瑞芬太尼与舒芬太尼靶控输注在腹腔镜手术麻醉中作用的对比分析

Comparative Analysis of Effects of Remifentanil and Sufentanil Target-controlled Infusion in the Anesthesia of Laparoscopic Surgery

目的:比较瑞芬太尼与舒芬太尼靶控输注在腹腔镜手术麻醉中的作用。方法:将82例择期接受腹腔镜手术的患者按就诊顺序编号,随机数字表法分为A组和B组,各41例,分别靶控输注瑞芬太尼和舒芬太尼,比较两组术后呼吸恢复时间、麻醉苏醒时间、拔管时间;比较两组患者麻醉前(T1)、气管插管后即刻(T2)、手术开始时(T3)、手术结束时(T4)的心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO2)的变化;同时于拔管30min后行Ramsay镇静评分,观察术后恶心呕吐发生率。结果:A组术后呼吸恢复时间、麻醉苏醒时间、拔管时间均较B组短(P<0.05);在T4时刻A组HR明显高于B组(P<0.05),MAP明显低于B组(P<0.05);T1~T4时刻两组患者SpO2比较差异无统计学意义(P>0.05);B组Ramsay评分高于A组(P<0.05),A组和B组苏醒期恶心呕吐发生率比较差异无统计学意义(P>0.05)。结论:与舒芬太尼相比,腹腔镜手术中靶控输注瑞芬太尼血流动力学稳定,可较大程度满足术后苏醒阶段的苏醒要求,但术后镇静效果不理想。

Objective:To compare the effects of Remifentanil and Sufentanil target-controlled infusion in the anesthesia of laparoscopic surgery.Method:A total of 82 patients who underwent selective laparoscopic surgery were numbered according to the treatment sequence and were divided into group A and group B according to the random number table method,with 41 cases in each group.The two groups were given target-controlled infusion of Remifentanil and Sufentanil respectively.The postoperative respiratory recovery time,anesthesia recovery time and extubation time were compared between the two groups.The heart rate(HR),mean arterial pressure(MAP) and blood oxygen saturation(SpO2) were compared between two groups before anesthesia(T1),immediately after tracheal intubation(T2),at the starting of surgery(T3) and at end of surgery(T4).Ramsay sedation score was performed at 30 min after extubation,and the incidence rate of postoperative nausea and vomiting was observed.Result:The postoperative respiratory recovery time,anesthesia recovery time and extubation time in group A were shorter than those in group B(P<0.05).At T4,the HR in group A was significantly higher than that in group B(P<0.05),while the MAP was significantly lower than that in group B(P<0.05).There was no significant difference in SpO2 between the two groups at T1-T4(P>0.05).The Ramsay score in group B was higher than that in group A(P<0.05).There was no statistically significant difference in the incidence rate of nausea and vomiting between group A and group B(P>0.05).Conclusion:Compared with Sufentanil,target-controlled infusion of Remifentanil has stable hemodynamics in gynecologic laparoscopic surgery,and it can meet the recovery requirements of postoperative recovery to a much greater extent,but it has unsatisfactory postoperative sedation effects.