舒芬太尼和芬太尼对男性患者全麻苏醒期导尿管留置反应的作用

Comparison of fentanyl with sufentanil on urethral catheter-related reaction after general anaesthesia in male adult patients

目的观察舒芬太尼和芬太尼对全麻苏醒期导尿管留置不适反应的作用。方法择期手术男性患者200例,年龄20～65岁,随机均分为舒芬太尼组(S组)、芬太尼组(F组)两组:S、F两组分别静注舒芬太尼0.5μg/kg或芬太尼5μg/kg、咪达唑仑0.04mg/kg、罗库溴铵0.9mg/kg、丙泊酚1.5mg/kg实施麻醉诱导。术中瑞芬太尼0.3μg.kg-1.min-1、丙泊酚4～6mg·kg-1.min-1泵入维持麻醉,阿曲库铵间断推注。两组均在全麻诱导后留置导尿管,手术结束前10min停用丙泊酚,S组追加舒芬太尼5μg,F组追加芬太尼50μg。苏醒期观察患者的BP、HR,对导尿管留置不适的影响程度进行评估。结果 S组术后血流动力学更平稳,中度以上导尿管不适发生率明显低于F组(P<0.01)。结论舒芬太尼比芬太尼更能减轻患者全麻苏醒期导尿管不适反应。

Objective To compare the effects of fentanyl and sufentanil on catheter-related discomfort after general anaesthesia. Methods Two hunder male adult patients, undergoing selective surgery, aged 20 to 65 years old, were randomized into two groups with 100 cases in each group. The patients in group S and group F were received anesthetic induction respectively with sufentanil 0.5ug/kg or fentanyl 5ug/kg. All patients accepted injection of midazolam 0.04mg/kg, rocuronium 0.9 mg/kg, and propofol 1.5 mg/kg, atracurium intermittent bolus.Then followed by remifentanil 0.3 ug/kg/min and propofol 4-6 mg/kg/min. After anesthesia induction, all patients were catheterized with a urethral catheter and the balloon was inflated with 10 ml distilled water. The bladder discomfort, MAP and HR were assessed during recovery period in PACU. Result Postoperative hemodynamic of group S is more stable , moderate and severe bladder discomfort were significantly lower than the F group （P 〈 0.01）. Conclusion Compared with fentanyl, sufentanil can significantly reduce thecatheter related discomfort after general anaesthesia.