阿芬太尼和舒芬太尼应用于无痛人工流产术麻醉效果及术后炎症反应比较

Comparative anesthetic effect of alfentanil and sufentanil for painless abortion of women and its influence on their postoperative inflammatory response

目的:探讨阿芬太尼用于无痛人工流产术麻醉效果及术后炎症反应。方法:选择本院自愿接受无痛人工流产手术者137例,随机分为阿芬太尼组(66例)和舒芬太尼组(71例),分别术中应用阿芬太尼10μg/kg或舒芬太尼0.15μg/kg,两组均应用丙泊酚维持镇静。记录受术者恢复时间和手术相关时间、丙泊酚用量和心肺并发症发生率。比较手术前后c-反应蛋白和白细胞水平。结果:阿芬太尼组丙泊酚用量(151.5±29.1mg)高于舒芬太尼组(123.2±28.3 mg),清醒时间(5.3±3.5 min)和恢复时间(10.8±2.6 min)低于舒芬太尼组(6.6±3.9 min、13.1±3.1 min)(均P<0.05);两组受术者平均动脉压下降变化情况、低氧血症和无创正压通气的发生,以及平均心率变化情况、心肺相关并发症、收缩性低血压、平均动脉压下降的发生率均无差异(P>0.05);阿芬太尼组应用血管活性药物比例低于舒芬太尼组,术后3h hs-CRP含量低于舒芬太尼组(均P<0.05),白细胞计数两组无差异(P>0.05)。结论:相较于舒芬太尼,无痛人工流产手术应用阿芬太尼可更有效镇痛,且恢复期更短,术中更平稳,术后炎症水平更低。

Objective:To compare the anesthetic effect of alfentanil and sufentanil for painless abortion of the women,and to study its influence on the postoperative inflammatory response painless abortion of the women.Methods:137 women who wanted painless abortion were selected and were randomly divided into group A(66 women given 10μg/kg of alfentanil for analgesia)and group B(71 women given 0.15μg/kg of fentanyl for analgesia),and the women in both groups were given propofol for maintain sedation.The wakening time and the total operation time,the propofol dosage,and the incidence of cardiopulmonary complications of the women in both groups were recorded.The C-reactive protein level and the white blood cell(WBC)count of the women in both groups were compared before and after abortion.Results:The dosage of propofol used(151.5±29.1mg)of the women in group A was significant higher than that(123.2±28.3 mg)of the women in group B,but the wakening time(5.3±3.5 min)and the recovery time(10.8±2.6 min)of the women in group A were significant lower than those(6.6±3.9 min and 13.1±3.1 min)of the women in group B(P<0.05).There were no significant differences in the decreasing values of mean arterial pressure,mean heart,and mean arterial pressure,and the rates of hypoxemia,non-invasive positive pressure ventilation,and the cardiopulmonary related complications of the women between the two groups(P>0.05).The proportion of vasoactive drug application of the women in group A was significant lower than that of the women in group B,and the level of hs-CRP at postoperative 3h of the women in group A was significant lower than that of the women in group B(all P<0.05).There was no significant difference in WBC count of the women between the two groups(P>0.05).Conclusion:Compared with those of fentanyl,alfentanil can effectively relieve pain of the women during abortion,with shorter recovery time,more stable during operation,and lower postoperative inflammatory level.