舒芬太尼复合异丙酚靶控输注在宫腔镜手术中的应用

Study on Sufentanil combined with target controlled infusion of propofol for hysteroscope operation

目的观察静脉注射舒芬太尼复合异丙酚靶控输往在官腔镜手术中的效果和安全性。方法选择60例ASAI～Ⅱ级宫腔镜手术患者，随机分为舒芬太尼复合异丙酚靶控输注组（S组），芬太尼复合异丙酚靶控输注组（F组）和异丙酚靶控输注组（P组），每组20例。观察三组患者MAP、HR、SpO2、RR，术中体动、术后睁眼时间和定向力恢复时间、异丙酚的总用量、以及恶心、呕吐等情况。结果与P组（335．9±54．4）mg相比，S组（173．5±47．71mg和F组（210．3±60．7）mg的异丙酚用量和术中体动减少，差异有显著性（P〈0．05）；S组的睁眼时间（3．2±1．6）min和定向力恢复时间（4．1±1．5）min较F组的睁眼时间（4．8±1．3）min和定向力恢复时间（5．9±3．2）min、P组的睁眼时间（5．0±1．8）min和定向力恢复时间（7．6±2．2）min短，差异有显著性（P〈0．05）；S组和F组患者血流动力学亦较平稳，呼吸抑制较P组轻（P〈0．05）；三组患者头昏及恶心等不良反应发生率差异无显著性（P〉0．05）。结论舒芬太尼复合异内酚靶控输注用于门诊官腔镜手术，异丙酚用量少，对生命体征影响小，镇痛效果好，术后苏醒迅速，值得临床推广使用。

Objective To evaluate the efficacy and safety of Sufentanil combined with target controlled infusion of propofol for hysteroscope operation. Methods 60 patients of ASA I - II undergoing Hysteroscope operation were randomly divided into three groups. In group S, patients were anesthetized with Sufentanil （0. 1ug/kg）and target controlled infusion of Propofol （3 ug/ml）, in group F, patients were anesthetized with fentanyl （lug/kg）and target controlled infusion of Propofol （3 ug/ml）, in group P, patients were anesthetized with target controlled infusion of Propofol （5 ug/ml）. HR, MAP, SpO2 were continuously monitored. The dosage of Propofol, limb movements, waking time, orientation recovery time were recorded. Results MAP and HR were significantly higher in group P than the rest during intraoperative period （ P 〈0.05）. The dosage of Propofol and the incidence of limb movements was reduced in group S and group F （ P〈0.05 ）. The waking time was （3.2 ± 1.6） min,（4.8 ± 1.3） min,（5.0± 1.8） min in grotlp S, group F and group P, respectively （P〈0.05）. The orientation recovery time was （4.1± 1.5） rain, （5.9 ± 3.2） min, （7. 6 ± 2.2） min in group S , group F and group P, respectively （P〈0.05）. Conclusion Snfentanil combined with target controlled infusion of propofol could offer a good sedation/analgesia during hysteroscope operation without significant side effects.