瑞芬太尼与舒芬太尼靶控输注在腹腔镜手术麻醉中的应用比较  

Comparison of application of remifentanil and sufentanil by target controlled infusion in laparoscopic surgery anesthesia

作　　者：吴黎黎[1] 李海红[2] 

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,北京100176 [2]牡丹江医学院红旗医院重症医学科,黑龙江牡丹江157011

出　　处：《中国临床研究》2018年第1期105-107,共3页Chinese Journal of Clinical Research

摘　　要：目的观察瑞芬太尼及丙泊酚靶控输注在腹腔镜手术麻醉中的应用及其效果和安全性,并与靶控输注舒芬太尼及丙泊酚对比。方法选取2014年9月至2016年1月接受全麻下腹腔镜手术的72例患者作为研究对象。将患者按照随机数字表法均分为对照组和研究组,各36例。对照组患者予以靶控输注舒芬太尼及丙泊酚进行麻醉,研究组患者予以靶控输注瑞芬太尼及丙泊酚进行麻醉。对比两组患者麻醉前(T0)、麻醉3 min(T1)、插管时(T2)以及拔管时(T3)的心率(HR)、收缩压(SBP)、舒张压(DBP)水平,比较两组术后恢复情况及丙泊酚用量。结果在T1时,两组患者HR、SBP及DBP较T0时明显降低(P均<0.05);在T3时,两组患者HR、SBP以及DBP较T1时明显升高(P均<0.05),且研究组患者各指标高于对照组(P均<0.05)。研究组患者的苏醒时间、拔管时间及诉求镇痛时间明显少于对照组(P均<0.01)。两组患者的丙泊酚用量对比差异无统计意义(P>0.05)。结论腹腔镜手术患者予以靶控输注瑞芬太尼及丙泊酚进行麻醉,能够有效改善患者HR、SBP及DBP水平,并有效缩短患者苏醒时间、拔管时间及诉求镇痛时间。Objective To observe the application,effect and safety of target controlled infusion（TCI） of remifentanil plus propofol and compare with sufentanil plus propofol in laparoscopic surgery anesthesia. Method A total of 72 patients undergoing general anesthesia for laparoscopic surgery from September 2014 to January 2016 were selected as research objects and randomly divided into control group （TCI of sufentanil and propofol anesthesia） and research group （TCI of remifentanil and propofol anesthesia） （n = 36,each）. The heart rate （HR）, systolic blood pressure （SBP） and diastolic blood pressure （DBP） were compared at the next time points： before anesthesia （ T0 ）, anesthesia for 3 rain （ T1 ）, at intubation （ T2 ） and at extubation （ T3 ）, and the postoperative recovery and the dosage of propofol were also compared between two groups. Results HR, SBP and DBP decreased obviously at T1 compared with TO and increased significantly at T3 compared with T1 in both two groups（all P 〈 0. 05）and were significant higher in research group than those in control group （ all P 〈 0. 05 ）. The waking time, extubation time and appealing for analgesia time in research group were significantly less than those in control group （ all P 〈 0. 01 ）. There was no significant difference in dosage of propofol in anesthesia between two groups（P 〉 0. 05 ）. Conclusion Anesthesia with target controlled infusion of remifentanil and propofol in patients undergoing laparoscopic surgery can effectively improve the levels of HR, SBP and DBP and shorten the time of recovery, extubation and appealing for analgesia.

关 键 词：腹腔镜手术 麻醉 瑞芬太尼 舒芬太尼 苏醒时间 拔管时间 诉求镇痛时间 丙泊酚用量 

分 类 号：R614.24[医药卫生—麻醉学]