舒芬太尼辅助全麻方案在子宫肌瘤手术中的麻醉效果

Anesthetic Effect of Sufentanil Assisted General Anesthesia Scheme in Hysteromyoma Surgery

目的:探讨舒芬太尼辅助全麻方案在子宫肌瘤手术中的效果。方法:前瞻性选取2022年4月—2024年3月于南昌大学第四附属医院行腹腔镜子宫肌瘤切除术的106例患者,以随机数字表法分成对照组(n=53)与观察组(n=53)。对照组采用芬太尼辅助全麻方案,观察组采用舒芬太尼辅助全麻方案。对比两组麻醉相关指标(拔管时间、自主呼吸恢复时间、苏醒时间、定向力恢复时间),对比两组麻醉前(T_(0))、插管后即刻(T_(1))、气腹建立后即刻(T_(2))、气腹建立后10 min(T_(3))、术毕时(T_(4))的平均动脉压(MAP)、心率(HR),对比两组应激指标[谷氨酸(Glu)、去甲肾上腺素(NE)、皮质醇(Cor)]水平及不良反应。结果:与对照组比较,观察组拔管时间、自主呼吸恢复时间、苏醒时间及定向力恢复时间均早,差异均有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3)、T_(4)时,与对照组比较,观察组MAP、HR水平均低(P<0.05)。术后3 d,相较于对照组,观察组Glu、NE、Cor水平均低(P<0.05)。观察组不良反应发生率低于对照组(5.66%vs 28.30%)(P<0.05)。结论:相较于芬太尼,应用舒芬太尼辅助全麻方案的子宫肌瘤手术患者术后恢复更快,血流动力学更稳定,且安全性高。

Objective:To investigate the effect of Sufentanil assisted general anesthesia scheme in hysteromyoma surgery.Method:A total of 106 patients undergoing laparoscopic myomectomy in the Fourth Affiliated Hospital of Nanchang University from April 2022 to March 2024 were prospectively selected and divided into control group(n=53)and observation group(n=53)by random number table method.The control group was treated with Fentanyl assisted general anesthesia scheme,and the observation group was treated with Sufentanil assisted general anesthesia scheme.Anesthesia-related indexes(extubation time,spontaneous breathing recovery time,emergence time and orientation recovery time)were compared between the two groups.The mean arterial pressure(MAP)and heart rate(HR)of the two groups were compared before anesthesia(T_(0)),immediately after intubation(T_(1)),immediately after pneumoperitoneum establishment(T_(2)),10 min after pneumoperitoneum establishment(T_(3))and at the end of surgery(T_(4)).The levels of stress indexes[glutamate(Glu),norepinephrine(NE),cortisol(Cor)]and adverse reactions were compared between the two groups.Result:Compared with control group,the extubation time,spontaneous breathing recovery time,emergence time and orientation recovery time in observation group were earlier,the differences were statistically significant(P<0.05).At T_(1),T_(2),T_(3) and T_(4),the MAP and HR levels in the observation group were lower than those in the control group(P<0.05).3 days after surgery,compared with control group,the levels of Glu,NE and Cor in observation group were lower(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group(5.66%vs 28.30%)(P<0.05).Conclusion:Compared with Fentanyl,patients undergoing hysteromyoma surgery with Sufentanil assisted general anesthesia scheme have faster postoperative recovery,more stable hemodynamics,and higher safety.