七氟醚或丙泊酚复合舒芬太尼麻醉在胸科手术的比较

Comparative analysis of sevoflurane-sufentanil and propofol-sufentanil anesthesia in thoracic surgery

目的比较分析七氟醚复合舒芬太尼和丙泊酚复合舒芬太尼两种在胸科手术中的临床应用效果。方法回顾性分析我院2008～2011年接受胸科手术的患者28例,ASAI-II级,按照麻醉方式分为S组和P组。S组14例行七氟醚复合舒芬太尼麻醉,P组14例行丙泊酚复合舒芬太尼麻醉。比较2组患者术中的平均动脉压力值、心率的变化、自主呼吸恢复时间、清醒情况、不良反应发生情况等。结果 2组患者麻醉诱导后与诱导前相比动脉压力值和心率显著降低(P<0.05),2组患者在麻醉期间以及麻醉结束后平均动脉压力值和心率变化值与麻醉诱导前差异无显著性(P>0.05)。S组和P组间不同时刻平均动脉压力值和平均心率变化值均无显著性差异(P>0.05)。2组自主呼吸恢复时间、首次睁眼时间差异均无显著性(P值均>0.05)。P组躁动发生率显著低于S组(P<0.05)。结论七氟醚复合舒芬太尼和丙泊酚复合舒芬太尼2种麻醉在胸科手术对机体动脉压力和心率无显著影响,不良反应发生率均较低。2种方法均可应用于胸科手术麻醉,但丙泊酚复合舒芬太尼效果更理想,术后苏醒更完善。

Objective To analyze the sevofIurane-sufentanil and propofol-sufentanil anesthesia in thoracic surgery and com- pare their clinical effect. Methods 28 patients, who had received thoracic surgery in our hospital from 2008 to 2010 ,were di- vided into S and P groups. 14 patients in S group underwent sevoflurane-sufentanil anesthesia and another 14 patients in P group received propofol-sufentani] anesthesia. The mean arterial pressure, heart rate changes, time of spontaneous breath recov- ery, first eye opening time and occurrence of adverse reaction of the two groups were compared. Results The mean arterial pressure and heart rates after induction were significantly lower than before induction （ P 〈 0.05 ）. In the course of anesthesia, the arterial pressure and heart rate values were not significantly different from those before induction （ P 〉 0.05 ）. Between group S and group P, the mean arterial pressure and heart rates at different times were not significantly different { P 〉 0.05 ）. Spontaneous breath recovery time and first eye opening time of group P were significantly shorter than group S { P 〈 0.05 ）. The incidence of agitation in group P was significantly lower than in group S { P 〈 0.05 ）. Conclusion Sevoflurane-sufentanil and propofol-sufentanil anesthesia in thoracic surgery have no significant effect on mean arterial pressure and heart rates. Both have low adverse reaction rate and can be applied to thoracic surgery anesthesia, but propofol-sufentanil anesthesia is advantageous in immediate effect and post-operational recovery.