丙泊酚联合不同剂量舒芬太尼对妇科手术患者痛觉及其血液流变学的影响

Effects of Propofol combined with different doses of Sufentanil on pain and hemorheology of gynecological patients

目的:探讨丙泊酚联合不同剂量舒芬太尼对妇科手术患者痛觉及其血液流变学的影响。方法:选取择期行妇科手术患者96例为研究对象,采用随机数表法分为S_1组、S_2组、S_3组和S_4组,每组各24例。其中,S_4组为对照,4组患者均给予2.0 mg/kg丙泊酚进行全麻诱导;S_1组、S_2组和S_3组患者在此基础上分别按等剂量给予持续输注0.3、0.5、0.6μg/kg舒芬太尼。麻醉前3 min(T_0)、术中(T_1)、术后20min(T_2)和术后30 min(T_3),记录各组患者各时间点平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO_2),并分析麻醉前及术后4、8、12、24、48 h,各组患者视觉模拟评分(VAS_),同时记录术后48 h内各组患者不良反应发生率。结果:T_1时、T_2时,S_2组和S_3组患者的MAP、HR、SPO_2明显降低(P<0.05),且T_2时,S_3组患者的MAP、HR、SPO_2下降明显(P<0.05);术后12、24、48 h,4组患者的VAS_评分均降低(P<0.05);S_2组患者的各时间点VAS_评分与S_3组比较,无统计学差异(P>0.05);4组患者的不良反应发生率分别为12.5%、16.7%、20.8%和8.3%,组间差异无统计学意义(P>0.05)。结论:妇科患者手术期间使用0.5μg/kg舒芬太尼联合丙泊酚麻醉效果较好,且对其血液流变学影响小,安全性高。

Objective To explore effects of Propofol combined with different doses of Sufentanil on pain and hemorheology ofgynecological patients. Methods： 96 cases of patients undergoing gynecological surgery selectively were selected as the research ob-jects, and they were divided into four groups according to the random number table： S1, S2 , S3 and S4（ n = 24cases in each group ）. Propofol 2. 0mg/kg was given for anesthesia induction during the operation for the four group; besides, the S1, S2 and S3 group were sustainably infused with isodose Sufentanil at 0.3, 0. 5, 0.6 g/kg, separately. The mean arterial pressure （ MAP） , heart rate （ HR）, and pulse oxygen saturation （SPO2 ） 3 min before anesthesia （T 0 ） , during the operation （T1） , 20 min （T 2 ） and 30 min （T 3 ） after the operation were recorded. Moreover, the visual analogue scores （VAS） before an aesthesiaand 4,8, 12, 24 and 48 h after the op-eration were analyzed, and the incidences of the adverse reactions within 48 h after the operation in the four groups were recorded. Re-sults ：At T1 and T2 , the MAP, HR, and SPO2 decreased significantly in S2 and S3 group （ P 〈 0 . 0 5 ） , and at T2 , MAP, HR and SPO2 decreased significantly in S3 group （P〈0.05） . 12 h, 24 h and 48 h after the operation, the VAS scores of the four groups were re-duced （P〈0. 05） ; however, there were no significant differences in the VAS scores at different time points between S2 and S3 group （P 〉0. 05）. There were no significant differences in the incidences of the adverse reactions in the four groups （12. 5%, 16. 7%, 20. 8%, 8 . 3% ） （P〉0. 05）. Conclusions ： 0. 5 μg /k g Sufentanil combined with Propofol for the gynecological surgery can make goodanesthetic effects with higher safety and less influence on hemorheology.