舒芬太尼与芬太尼用于全麻下脊柱矫形术中唤醒效果的比较

Comparison on wake-up time of sufentanil and fentanyl on intraoperative wake-up test in general anesthesia patients undergoing spinal correction surgery

目的：对比研究舒芬太尼与芬太尼对脊柱畸形矫形术中唤醒时间及质量的影响，探讨在脊柱畸形矫形术中唤醒试验的操作方法，评估唤醒效果。方法：脊柱畸形矫形患者38例，随机均分为舒芬太尼组和芬太尼组各19例。两组麻醉诱导均用咪唑安定0.1mg／kg、丙泊酚1.5～2.0mg／kg、阿曲库铵0.15～0．20mg／kg、舒芬太尼0.2ptg／kg或芬太尼4.0／μg／kg静脉注射，用舒芬太尼0.1pg／（kg·h）或芬太尼1.0弘g／（kg·h）持续泵入维持术中镇痛，术中在需要唤醒前30min左右停止阿曲库铵、舒芬太尼或芬太尼泵入，在需要唤醒时停止丙泊酚泵入，进行唤醒，比较唤醒时间和唤醒质量。结果：在舒芬太尼与芬太尼用于脊柱畸形矫形术中唤醒试验的比较中两组患者性别、年龄、体重、手术时间和出血量差异无统计学意义；舒芬太尼组患者自主呼吸恢复时间、呼之睁眼时间及指令动作恢复时间均短于芬太尼（P〈0.05）。唤醒成功时，唤醒质量比较舒芬太尼纽优于芬太尼（P〈0．05）。芬太尼患者出现1例术中疼痛及知晓，两组术后均无其他麻醉并发症。结论：该术中唤醒试验方法能快速实现脊柱畸形矫形术的术中唤醒，舒芬太尼与芬太尼相比唤醒时间更短、唤醒质量较高。

AIM： To research the effect of sufentanil and fentanyl on intraoperative wake- up time and quality in patients undergoing spinal correction surgery, and to study the operation method of intraoperatie wake-up test of spinal correction surgery, and further evaluate the effect of wake-up test. METHODS： Thirty eight cases of patients with spinal deformity were trea-ted by spinal correction surgery. They were ran- domly divided into sufentanil group and fentanyl group with 19 patients in each group. The anes-thesia induction was begun with intravenous in-fusion 0.1 mg/kg midazolam, 1.5-2.0 mg/kg propofol, 0.15-0.20 mg/kg atracurium and 0.2 /μg/kg sufentanil or 4.0 μg/kg fentanyl. The an-esthesia was maintained with continuous pump injection sufentanil 0.1 /μg/（kg·h） or fentanyl 1/μg/（kg·h）. Atracurium, sufentanil or fenta-nyl were stopped pump injection in the time of 30 rain before needing awakening. The pump in-jection of propofol in the time of need awakening was stopped, and the process of waking up was begun. The wake-up time and quality were stud-ied. RESULTS： The eratlon time were gender, age, weight and op- no statistically significant differences between sufentanil group and fenta-nyl group during the research. The recovery time of spontaneous breathing, open eyes, in- struction moves of sufentanil group were shorter than fentanyl group （P〈0.05）. The wake-up quality of sufentanil group was better than fent- anyl group （P〈0.05）. There was 1 case of pa- tients with intraoperative pain and awareness in fentanyl group. Both groups had no other com-plications. CONCLUSION： This method of intra- operative wake-up test is fast and effective. The wake-up time of the anesthesia which used sufentanil is shorter than those of fentanyl group, and the wake-up quality is higher than the later.