舒芬太尼与静脉复合麻醉患者苏醒期急性疼痛的剂量-反应关系

Dose-Response Relationship Between Sufentanil and Acute Pain in Patients Undergoing Combined Intravenous Anesthesia

目的:探索舒芬太尼与静脉复合麻醉患者苏醒期急性疼痛的剂量-反应关系。方法:选取2019年4月—2021年5月我院收治的162例实施静脉复合麻醉患者为试验对象,根据等距抽样法分为三组,每组54例。三组均在手术结束时停止输注瑞芬太尼和丙泊酚,缝皮前静脉注射舒芬太尼,A组、B组、C组剂量分别为0.1μg/kg、0.2μg/kg、0.4μg/kg,比较三组麻醉后拔管时间、自主呼吸恢复时间、呼唤睁眼时间以及各时间段血液流变学、镇静镇痛评分、躁动率。结果:A组、B组呼唤睁眼、自主呼吸恢复、拔管时间短于C组(P<0.05);A组、B组HR、MAP改善稳定情况优于C组(P<0.05);B组和C组Ramsay评分、VAS评分改善稳定情况优于A组(P<0.05);B组、C组患者术后6h、术后24h、术后48h的躁动率均低于A组(P<0.05)。结论:舒芬太尼静脉复合麻醉能够获取显著镇静、镇痛作用,选择0.2μg/kg剂量可更好地稳定血流动力学,降低术后躁动率。

Objective:To explore the dose-response relationship between sufentanil and acute pain during the recovery period of intravenous combined anesthesia.Methods:A total of 162 patients with intravenous anesthesia admitted to our hospital from April 2019 to May 2021 were selected as subjects.According to the isometric sampling method,they were divided into three groups,54 cases in each group.Remifentanil and propofol were stopped at the end of the operation in the three groups.Sufentanil was injected intravenously before skin suture.The doses of group A,group B and group C were 0.1μg/kg,0.2μg/kg and 0.4μg/kg,respectively.The extubation time,spontaneous breathing recovery time,calling and opening time,hemorheology,sedation and analgesia score and agitation rate in each period were compared among the three groups.Results:The time of eye opening,spontaneous breathing recovery and extubation in group A and group B were shorter than those in group C(P<0.05).The improvement and stability of HR and MAP in group A and group B were better than those in group C(P<0.05).Ramsay score and VAS score in group B and group C were better than those in group A(P<0.05).The agitation rate of group B and group C was lower than that of group A at 6 h,24 h and 48 h after operation(P<0.05).Conclusion:Sufentanil combined intravenous anesthesia can obtain significant sedative and analgesic effects.Choosing 0.2μg/kg dose can better stabilize hemodynamics and reduce postoperative agitation rate.