靶控输注舒芬太尼与瑞芬太尼全身麻醉对正颌手术患者术后苏醒质量的影响

The influence of sufentanil TCI versus remifentanil TCI on the quality of recovery after orthognathic surgery

目的:比较靶控输注( TCI)舒芬太尼( SF)与瑞芬太尼(RF)全凭静脉麻醉对正颌手术术后苏醒质量的影响。方法:纳入正颌手术患者40 例,随机分为SF 组和RF 组( n = 20)。离断颏部骨组织后,SF 组设定SF 效应室靶浓度0. 2 ng /ml,RF 组给予SF 0. 2 μg /kg 并设定RF 2 ng /ml 至出室。记录自主呼吸恢复、拔管、术后第一次按压镇痛泵时间;记录平均动脉压( MAP)及心率( HR),Ramsay 及视觉模拟评分( VAS)。结果: 2 组患者自主呼吸恢复及拔管时间差异无统计学意义( P > 0. 05);患者第一次按压镇痛泵的时间,SF 组较晚( P < 0. 05);RF 组Ramsay 评分较低( P < 0. 05),SF 组VAS 评分较低( P < 0. 05)。结论:正颌手术术中TCI 舒芬太尼可以获得更好的术后苏醒质量。

Objective: To assess the effects of sufentanil( SF) and remifentanil( RF) administered using target-controlled infusion ( TCI) on postoperative recovery quality in patients after orthognathic surgery. Methods: 40 adult patients scheduled for orthognathic surgery were randomly divided into 2 group ( n = 20),using Sufentanil-propofol TCI ( SF group) and remifentanil-propofol TCI ( SF group) respectively for anesthesia. When the chin bone had been cut,in the SF group,targeted the effect-site concentration of SF was set at 0. 2 ng /ml;in the RF group,SF 0. 2 μg /kg bolus was administrated i. v. with the effect-site concentration of 2 ng /ml of RF was set. Results: The recovery time to spontaneous breathing and tracheal extubation time was similar in the 2 groups( P > 0. 05). The Ramsay score was lower and the visual analogue scale were greater in the RF group than those in SF group( P < 0. 05). Conclusion: TCI sufentanial obtained a better quality than TCI remifentanial of recovery after the orthognathic surgery.