纳布啡与舒芬太尼复合丙泊酚麻醉诱导对宫腔镜手术患者脑电双频指数及麻醉复苏影响

Effcts of anesthetic induction with nalbuphine and sufentanil combined with propofol during the hysteroscopic surgery of patients on their bispectral index and anesthetic resuscitation

目的:探讨纳布啡与舒芬太尼复合丙泊酚麻醉诱导对宫腔镜手术患者脑电双频指数及麻醉复苏的影响。方法:选取2021年4月-2022年5月于本院接受宫腔镜手术患者60例,随机数字表法将分为纳布啡组(n=30)和舒芬太尼组(n=30),纳布啡组予以纳布啡复合丙泊酚麻醉诱导,舒芬太尼组予以舒芬太尼复合丙泊酚麻醉诱导。比较两组麻醉前5 min(T0)、睫毛反射消失开始扩宫时(T1)、手术中(T2)、手术结束时(T3)和麻醉苏醒时(T4)的收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO_(2))水平及脑电双频指数(BIS);比较两组丙泊酚诱导剂量、维持剂量、总剂量、总给药时间、单位时间剂量、麻醉苏醒时间及T4时疼痛数字评价量表(NRS)评分;两组不良反应发生情况。结果:SBP、DBP、HR、SpO_(2)水平两组T1~T4时均低于T0时,且舒芬太尼组低于纳布啡组;纳布啡组丙泊酚诱导剂量(110.90±14.95mg)、维持剂量(133.83±26.77mg)、总给药时间(18.70±4.31min)、麻醉苏醒时间(10.43±1.17min)及T4时NRS评分(0.03±0.18分)均低于舒芬太尼组(121.30±18.15mg、155.33±40.32mg、22.60±6.72min、21.33±3.34min、0.30±0.47分),T3舒芬太尼组BIS值(54.17±4.47)高于纳布啡组(51.67±4.02);纳布啡组术中、麻醉恢复期不良反应总发生率(20.0%)低于舒芬太尼组(46.7%)(均P<0.05)。结论:两种方案应用于宫腔镜手术均有良好麻醉效果,而纳布啡复合丙泊酚麻醉诱导在维持患者生命体征及缩短镇静诱导时间、减少丙泊酚剂量等方面优于舒芬太尼复合丙泊酚,且安全性更好。

Objective:To investigate the effects of anesthetic induction with nalbuphine and sufentanil combined with propofol during the hysteroscopic surgery of patients on their bispectral index and anesthetic resuscitation.Methods:60 patients who wanted hysteroscopic surgery were selected and were divided into two groups(30 cases in each group)by random number table method between April 2021 and May 2022.The patients in group A were given anesthesia induced by nalbuphine combined with propofol and the patients in group B were given anesthesia induced by sufentanil combined with propofol.The values of systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),oxygen saturation(SpO_(2)),and bispectral index(BIS)of the patients at 5 min before anesthesia(T0),at starting to dilate when the eyelash reflex disappeared(T1),during surgery(T2),at the end of surgery(T3),and at awakening from anesthesia(T4)were compared between the two groups.The doses of induction,maintenance,and total of propofole,the total administration time,the dose in unit time,the awakening time from anesthesia,and the score evaluated by pain numeric rating scale(NRS)at T4,and the adverse reaction rate of the patients were compared between the two groups.Results:The values of SBP,DBP,HR,and SpO_(2) of the patients in the two groups at T1-T4 were significantly lower than those at T0,and which of the patients in group B was significantly lower than those of the patients in group A.The induction dose of propofol(110.90±14.95mg),the maintenance dose(133.83±26.77mg),.and the total administration time(18.70±4.31 min)of propofole,the awakening time(10.43±1.17min),and the NRS score at T4(0.03±0.18 points)of the patients in group A were all significantly lower than those(121.30±18.15mg,155.33±40.32mg,22.60±6.72min,21.33±3.34min,and 0.30±0.47 min)of the patients in group B.The BIS value(54.17±4.47)of the patients in group B at T3 was significantly higher than that(51.67±4.02)of the patients in group A.The total incidence of the adverse reactions(20.0%)during surgery and period of awakening from anesthesia of the patients in group A was significantly lower than that(46.7%)of the patients in group B(all P<0.05).Conclusion:.Both regimens of anaesthetic induction used during hysteroscopic surgery of the patients have effectiveness.The anaes-thetic induction with nalbuphine compounded with propofol is significantly superior to sufentanil compounded with propofol in maintaining the vital signs of the patients,in shortening sedation induction time,and in reducing propofol dose,with better safety.