舒芬太尼与芬太尼复合异丙酚静脉麻醉的比较

A comparison of sufentanil and fentanyl in total intravenous anesthesia

目的:比较舒芬太尼与芬太尼复合异丙酚静脉麻醉时的作用。方法:选择40例ASA Ⅰ～Ⅱ级腹部手术病人。随机分为舒芬太尼-异丙酚静脉复合麻醉组(Suf组)和芬太尼-异丙酚静脉复合麻醉组(F组)。分别观察围术期血液动力学及血浆肾上腺素(E)、去甲肾上腺素(NE)水乎的变化以及苏醒时间。结果:Suf组除了在诱导2分钟时SP、DP、HR、RPP较诱导前明显下降(P<0.01),其它各测定时点无显著性差异(P>0.05);F组在诱导后2分钟,上述指标亦明显下降(P<0.01),而插管后1分钟较诱导前升高的幅度明显大于Suf组。F组RPP各测量点与Suf组相比明显升高(P<0.01);血浆儿茶酚胺浓度的升高,F组较Suf组明显。苏醒时间Suf组较F组明显缩短(P<0.01)。结论:等效剂量的Suf组较F组对血液动力学的影响更小,应激反应更轻,苏醒更快。

Objective: To compare effects of sufentanil with fentanyl when combined with propofol in intravenous anesthesia. Method: Forty ASA grade Ⅰ-Ⅱ patients, scheduled for abdominal operations, were randomly divided into two groups. Group sufentanil(Suf): combining sufentanil with propofol; group fentnyl (F): combining fentanyl with propofol. The items observed were perioperative hemodynamics, plasma epinephrine and norepinephine levels and analepsia time. Result: In group Suf, SP, DP, HR and RPP were decreased significantly (P<0.05)in two minutes after induction. And no statistical changes occurred afterward(P>0.05). In group F, the values above were also significantly decreased (P<0.01). In group F the differences between the values of one minute after intubation and the pre-inductive levels were higher than those in group Suf. RPP in group F was significantly higher than that in group Suf(P<0.01). The plasma catecholamine concentration increment in group F was higher than that in group Suf. And the analepsia time in group Suf was shorter than that in group F(P<0.01). Conclusion: Comparing with the equipotent dosage of fentanyl, sufentanil has less hemodynamic changes and minor stress reaction when combined with propofol in total intravenous aneathesia.