舒芬太尼与芬太尼在食道癌手术中的对比观察

Comparison of Sufentanil and fentanyl in esophageal cancer operation

目的观察丙泊酚联合芬太尼、舒芬太尼持续静脉输注在食道癌手术中的应用效果。方法食道癌手术患者83例,年龄42～78岁,性别不限,ASAⅠ～Ⅱ级;随机分成芬太尼组(41例)、舒芬太尼组(42例)。监测术中血流动力学变化,观察患者术后VAS疼痛和并发症情况。结果芬太尼组在开胸、胸内手术期、关胸时平均动脉压(MAP)、心率(HR)均明显高于基础值(P<0.05),舒芬太尼组在开胸、胸内手术期、关胸时平均动脉压(MAP)、心率(HR)均低于基础值(P<0.05);术后1、2、4小时舒芬太尼组VAS疼痛评分明显低于芬太尼组(P<0.05);术后恶心呕吐(PONV)发生率芬太尼组明显高于舒芬太尼组(P<0.05)。结论舒芬太尼联合丙泊酚持续静脉输注用于胸科食道癌手术优于芬太尼,术后镇痛作用舒芬太尼明显优于芬太尼。

Objective To compare effects of sufentanil with fentanyl when combined with propofol on patients undergoing esophageal carcinoma surgery. Methods 83 ASA grade I-IIpatients with Esophageal carcinoma were randomly divided into two groups （sufentanil group and fentanyl group）. The items observed were operative hemodynamics, VAS pain and complication. Results Fentanyl group on Mean Artery Pressure（MAP）, Heart Rate（HR） during opening or closing chest or intraoperative period is significantly higher than basic evaluations（P,〈0. 05, but sufentanil group is lower than basic evalutions opening or closing chest or intraoperative period（P〈0.05） ~VAS grades at lh, 2h, 4h points after operations, sufentanil group is significantly lower than fentanyl group（P〈0. 05）Post-operative Nausea and Vomi- ting （PONV）rate of fentanyl group is significantly higher than sufentanil group group（P〈0.05）. Conclusion Sufenanil combining with propofol is superior to fentanyl, in thoracic surgery anesthesia with esophageal cancer patients by continuous intravenous infusion.