不同剂量的舒芬太尼麻醉诱导对眼底病患者血流动力学和术后疼痛的效果对比

Comparison of the Effects of Anesthesia Induction with Different Doses of Sufentanil on Hemodynamics and Postoperative Pain in Patients with Ocular Fundus Diseases

目的:对比分析不同剂量的舒芬太尼用于眼底病麻醉诱导时对患者血流动力学和术后疼痛的效果。方法:选取郑州市第二人民医院2018年7月至2020年9月期间收治的150例择期行全麻眼底手术患者为研究对象,将患者简单随机分为A组、B组、C组,每组均为50例,三组患者依次使用0.2μg/kg、0.3μg/kg、0.4μg/kg舒芬太尼进行麻醉诱导,比较三组患者术后苏醒情况,麻醉诱导前(T)、诱导后(T)、喉管置入后(T)、喉管置入后5 min(T)、喉管置入后10 min(T)的血流动力学指标变化,以及术后1 h、4 h的镇静情况、疼痛情况,统计术后不良反应发生率。结果:三组患者自主呼吸恢复时间、拔喉罩时间、睁眼时间、PACU滞留时间比较差异无统计学意义(P>0.05);T时刻,三组患者生命体征指标MAP、SBP、HR差异无统计学意义(P>0.05);T~T时刻,A组患者上述指标均升高,C组患者上述指标均显著降低(P<0.05),而B组指标差异无统计学意义(P>0.05);三组患者术后1 h、4 h的Ramasay镇静评分(RSS)比较差异无统计学意义(P>0.05),B组患者术后24 h、48 h的视觉模拟评分量表(VAS)评分均低于A、C两组(P<0.05);三组患者术后不良反应发生率分别为8.00%、6.00%、6.00%(P>0.05)。结论:眼底病麻醉诱导时使用0.3μg/kg舒芬太尼,可较好地维持血流动力学稳定,减轻术后疼痛,安全性高。

Objective:To comparatively analyze the effects of different doses of sufentanil applied in anesthesia induction on hemodynamics and postoperative pain in patients with ocular fundus diseases.Methods:A total of 150 patients undergoing elective fundus surgery under general anesthesia in The Second People’s Hospital of Zhengzhou were selected as the research subjects between July 2018 and September 2020.They were randomly divided into group A,group B and group C,with 50 patients in each group.Patients in the three groups were given anesthesia induction with 0.2μg/kg,0.3μg/kg and 0.4μg/kg of sufentanil,respectively.Postoperative recovery,changes in hemodynamics indexes before anesthesia induction(T),after induction(T),after laryngeal mask placement(T),5 minutes after laryngeal mask placement(T)and 10 minutes after laryngeal mask placement(T),sedation and pain at 1 h and 4 h after operation were compared among the three groups.The incidence of postoperative adverse reactions were calculated.Results:There was no significant difference in spontaneous breathing recovery time,laryngeal mask removal time,eye-opening time and PACU stay among the three groups(P<0.05).There was no significant difference in vital signs MAP,SBP and HR among the three groups at T(P>0.05).T-T,the above indicators were increased in group A,and were reduced in group C(P<0.05),but there was no significant change in group B(P>0.05).There was no significant difference in the Ramasay Sedation Scale(RSS)score among the 3 groups at 1 h and 4 h after operation(P>0.05).Group B had significantly lower Visual Analogue Scale(VAS)scores than group A and group C at 24 h and 48 h after operation(P<0.05).The incidences of postoperative adverse reactions in the 3 groups were 8.00%,6.00%and 6.00%,respectively(P>0.05).Conclusion:Using 0.3μg/kg of sufentanil during anesthesia induction for fundus disease can better maintain hemodynamic stability,and reduce postoperative pain,with good sedative effect and high safety.