舒芬太尼复合异丙酚麻醉对宫腔镜手术血流动力学、脑电双频指数及麻醉恢复的影响

The effects of sufentanil combined propofol anesthesia on hemodynamic, electrical double-frequency index and anesthesia recovery of hysteroscopy surgery

目的探讨舒芬太尼复合异丙酚麻醉对宫腔镜手术血流动力学、脑电双频指数(BIS)及麻醉恢复的影响。方法选择80例ASA I~Ⅱ级宫腔镜手术患者,随机分为两组:舒芬太尼异丙酚静脉麻醉组(A组)和芬太尼异丙酚静脉麻醉组(B组),每组40例。于注药前(T0)、诱导结束时(T1)、扩张宫颈(T2)、手术结束(T3)和术毕清醒(T4)时比较两组患者的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏氧饱和度(Sp O2)、BIS值以及呼之睁眼和定向力恢复时间、手术时间、异丙酚的总量和术后恶心、呕吐等不良反应发生情况。结果与T0相比,两组SBP、DBP、HR和Sp O2变化趋势相同,但B组患者较A组波动更为明显,两组之间比较,在T1和T2时两组的SBP、DBP和HR比较,差异有统计学意义(P<0.05)。两组术中麻醉深度评估,T1、T2时A组患者的BIS数值明显低于B组,差异有统计学意义(P<0.05)。B组睁眼时间、定向力恢复时间均明显长于A组,而B组的异丙酚用量明显多于A组,差异有统计学意义(P<0.05);对两组患者的手术时间和恶心、呕吐等不良反应的发生率进行比较,差异无统计学意义(P>0.05)。结论异丙酚复合舒芬太尼麻醉应用于宫腔镜手术,能够达到理想的麻醉效果,且更有利于患者血流动力学的稳定,睁眼时间、定向力恢复时间更迅速,麻醉质量更高、更安全。

Objective To study the effects of sufentanil combined propofol anesthesia on hemodynamic, electrical double-frequency index and anesthesia re-covery of hysteroscopy surgery. Methods 80 patients in hysteroscopy surgery with ASA I-Ⅱ grade were chosen and randomly divided into two groups, sufentanil propofol intravenous anesthesia group（group A） and fentanyl propofol intravenous anesthesia group（group B）, 40 cases in each group. Before the drug infusion（T0）, at the end of the induction（T1）, expansion cervical（T2）, the end of the surgery（T3） and the waking （T4）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate（HR）, pulse oxygen saturation（SpO2）, BIS values, and eye opening time and directional force recovery time, operation time, the amount of propofol and postoperative adverse reactions such as nausea, vomiting occurred were compared between two groups. Results Compared with the indexes on T0, SBP, DBP, HR and SpO2 of two groups at another time changed same trend, but the fluctuations in group B was more apparent than that in group A. At T1 and T2, the differences of SBP, DBP and HR between the two groups were statistically significant （P 〈0.05） . At T1, T2, BIS value of group A was lower than that of group B（P〈0.05） . Time of Open eye, directional force recovery time of B group were significantly longer than those of group A, and the dosage of propofol of group B was significantly more than that of group A（P 〈0.05） . There was no statistically significant difference in the incidence of adverse reactions between two groups（P〉0.05） . Conclusion Propofol composite sufentanil anesthesia on hysteroscopy surgery, can achieve the ideal anesthetic effect, and more conducive to patients with hemodynamic stability, eye opening time, directional force recovery time more quickly, anesthesia higher quality, more safety.