舒芬太尼与丙泊酚全凭静脉麻醉在妇科腹腔镜手术中的应用  

The application of total intravenous anesthesia with Sufentanil and Propofol in gynaecologic laparoscopically operation

作　　者：刘东[1] 王超[1] 徐勇[1] 孙雪梅[1] 

机构地区：[1]成都市第二人民医院麻醉科,四川成都610017

出　　处：《中国计划生育和妇产科》2010年第3期35-37,共3页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的评价舒芬太尼与丙泊酚全凭静脉麻醉应用于妇科腹腔镜手术的可行性及安全性。方法选择麻醉前按美国麻醉医师协会(American society of anesthesiologists,ASA)评估Ⅰ～Ⅱ级40例择期妇科腹腔镜手术患者,随机分为两组,舒芬太尼组(SF组)、芬太尼组(F组),每组20例。两组麻醉诱导时再给予咪达唑仑0.04mg/kg,丙泊酚2.0mg/kg,维库溴胺诱导气管插管。麻醉维持:两组均持续输注丙泊酚,根据血压调整输注速度。术中根据需要可单次追加舒芬太尼5μg或芬太尼50μg。观察诱导前、诱导时、切皮时血压、心率,记录两组患者清醒时间及拔除气管导管时间;记录手术时间、定向力恢复时间;记录拔除气管导管时及离开手术室时、离开后1小时的意识状态评分。结果舒芬太尼与芬太尼相比麻醉期间维持血压更加稳定、有良好的中枢抑制效能、清醒时间及拔除气管导管时间短、意识状态评分高。结论舒芬太尼与丙泊酚全凭静脉麻醉用于妇科腹腔镜手术,诱导期血流动力学稳定,镇痛镇静满意,苏醒质量高,非常适合妇科腹腔镜手术。Objective To study the effects and safety of Sulfentanil and Fentanyl in total intravenous anesthesia（TIVA） in gynaecologic laparoscopically operation.Methods Forty patients grade I-Ⅱ according to America society of anesthesiologists（ASA） who would be performed gynaecologic laparoscopy operation were randomly divided into two groups：Sufentanil group（group SF,n=20）and Fentanyl group（group F,n=20）.Patients received Midazolan（0.04 mg/kg）,Sufeutanil（0.3 μg/kg） or Fentanyl（3 μg/kg）,Propofol（2.0 mg/kg）and vecuronium intravenously for anesthesia induction.The anaesthesia was maintained with Propofol continuous intravenous infusion and the propofol infusion rate was adjusted according to the blood pressure.Sufentanil（5 μg） or Fentanyl（50 μg） was intravenously administrated in addition if necessary during the operation.The heart rate （HR）,systolic blood pressure （SBP）,diastolic blood pressure （DBP） and mean arterial pressure （MAP） were recorded.Conscious state was assessed by the observer＇s assessment of anaesthesia /sedation scale（OAA/S）.Results Patients in Sufentanil group had more stable blood pressure intra-operatively,shorter recovery time and tracheal extracted time,higher OAA/S scale post operatively than that in Fenlanyl group. Conclusion TIVA with Sufentanil and Fentanyl may be suitable for gynaecologic laparoscopy operation with hemodynamic stability and well anesthetic effect in induction and recovery.

关 键 词：舒芬太尼 芬太尼 丙泊酚 全凭静脉全麻 妇科腹腔镜手术 

分 类 号：R713[医药卫生—妇产科学]