舒芬太尼与瑞芬太尼复合异丙酚在宫腔镜电切术麻醉中效果比较研究

Comparison of the Effects between Sufentanil and Remifentanil with Propofol Anaesthesia for Hysteroscopic Surgery

目的：比较舒芬太尼与瑞芬太尼复合异丙酚在宫腔镜电切术麻醉中的临床效果。方法：选择ASAⅠ一Ⅱ级接受官腔镜电切术的患者60例，随机分为两组，每组30例。R组为瑞芬太尼组（瑞芬太尼＋异丙酚），S组为舒芬太尼组（舒芬太尼＋异丙酚）。静脉给药，待患者意识消失后开始手术，术中两组分别持续泵注瑞芬太尼和舒芬太尼，患者有体动时追加异丙酚0．5—0．8mg／kg。观察并记录术中受术者心率、血压、呼吸、血氧饱和度的变化异丙酚用量及术后苏醒时间、定向力恢复时间、镇静评分、视觉模拟评分和不良反应。结果：两组受术者心率、血压、呼吸、血氧饱和度术中均有一定程度下降（P〈0．05），但组间无统计学意义（P〉0．05）；术毕清醒时间、定向力恢复时间、镇静评分无统计学意义（P〉0．05）；s组宫缩痛发生率明显低于R组（P〈0．05）。结论：舒芬太尼复合异丙酚麻醉（诱导：舒芬太尼0．1灿g／kg＋异丙酚2mg／kg；维持：舒芬太尼0．3pg／kg·h）应用于门诊宫腔镜电切术，能够更加有效地抑制或减轻受术者术后宫缩痛，提高满意率。

Objective： To compare the effects between remifentanil and sufentanil combined with propofol in hysteroscopic surgical anaesthesia. Methods ： Sixty ASA Ⅰ-Ⅱ patients who underwent hysteroscopic surgery were randomly divided into two groups with 30 patients in each group. The patients in group R were given propofol （2mg/kg） and remifentanil （ 1μg/kg） , and the patients in group S were given propofol （2mg/kg） and sufentanil（0, μg/kg） for induction. Remifentanil and sufentanil were separately infused in two groups for maintenance during the operations, and moreover propofol （0.5- 0.8 mg/kg） were added according to the patients＇ response. Not only the changes of heart rate, blood pressure, respiratory rate, oxygen saturation and propofol doses were observed, but also post - operation revival time, recovery time of orientation, sedation scores, visual analog scale（VAS） and side effects were recorded. Resuts： Post -operation heart rate, blood pressure, respiratory rate, and oxygen saturation were lower in both two groups （ P 〈 0.05 ）, but they showed no difference between two groups （ P 〉 0.05 ）. Post - operation revival time, recovery time of orientation and sedation scores showed no difference between two groups （ P 〉 0.05 ）, while post - operation VAS in group R were markedly higher than that in group S. Conclusion： Sufentanil with propofol（ induction： sufentanil 0.1 μg/kg ＋ propofol 2mg/kg;maintenance：sufentanil 0.31μg/kg·h） is suitable for hysteroscopic surgical anaesthesia and can inhibit postoperative metralgia.