靶控输注舒芬太尼复合丙泊酚在腰椎手术中的效应分析

Effect analysis of target-controlled infusion of sufentanil combined with propofol in lumbar surgery

目的探讨靶控输注舒芬太尼复合丙泊酚在腰椎手术中血流动力学变化及镇痛效果。方法选取2016年1月~2017年12月于我院择期行腰椎手术的30例患者为研究对象,采用随机数字表法分组,每组15例。对照组采用丙泊酚复合瑞芬太尼联合靶控输注麻醉,观察组采用丙泊酚复合舒芬太尼靶控输注麻醉,对比两组诱导及术中血流动力学、丙泊酚用量、苏醒时间及术后镇痛效果。结果与麻醉诱导前相比,观察组患者在切开皮肤时和上内固定钉时的血压、心率均明显降低,且明显低于对照组,差异有统计学意义(P<0.05),两组在拔管后10min时的血压和心率,差异无统计学意义(P>0.05)。观察组的丙泊酚用量少于对照组,差异有统计学意义(P<0.05);两组患者的术后苏醒时间无统计学意义(P>0.05);观察组患者的拔管后、拔管后6小时VAS评分以及镇痛泵按压次数均明显优于对照组,差异有统计学意义(P<0.05)。结论在腰椎手术中运用靶控输注舒芬太尼复合丙泊酚的降压方案可有效控制患者的血流动力学指标,有平稳的降压效果,可减少麻醉药物的使用剂量,患者术后苏醒快,麻醉效果理想,值得推广和应用。

Objective To investigate the hemodynamic changes and analgesic effect of target controlled infusion of sufentanil combined with propofol in lumbar surgery.Methods Thirty cases undergoing elective lumbar surgery in our hospital were selected from January 2016 to December 2017,and divided into groups by digital random expression,each with 15 cases,the control group was treated with propofol combined with remifentanil and target controlled infusion anesthesia.The observation group received propofol combined with sufentanil for target controlled infusion anesthesia.The induction and intraoperative hemodynamics,propofol dosage,recovery time and postoperative analgesia effect of the two groups were compared.Results Compared with the anesthesia induction,the blood pressure and heart rate of the patients during the incision and the upper internal fixation were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in blood pressure and heart rate between the two groups at 10min after extubation(P>0.05).The dosage of propofol in the observation group was less than that of the control group,and the difference between the two groups was statistically significant(P<0.05);the recovery time of the two groups was not statistically significant(P>0.05),and the score of VAS after extubation,6 hours after extubation and the press times of the analgesic pump were significantly better than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of the target controlled infusion of sufentanil and propofol in the lumbar operation can effectively control the hemodynamic index of the patients.It has a stable effect of hypotension,which can reduce the dosage of the anesthetic.The patients wake up quickly after operation,and the effect of anesthesia is ideal.It is worth popularizing and should be used.