等效镇痛剂量舒芬太尼与芬太尼在腹腔镜子宫切除术全凭静脉麻醉中对患者应激反应的影响  

Effect of equivalent analgesic dose of sufentanil and fentanyl on stress response in laparoscopic hysterectomy with total intravenous anesthesia

作　　者：党炳文 马志兵 贺峰[1] 惠勇[1] 霍鹏伟 张成江[1] DANG Bing-wen;MA Zhi-bing;HE Feng;HUI Yong;HUO Peng-wei;ZHANG Cheng-jiang(Yulin No.2 Hospital,Yulin 719000,China)

机构地区：[1]榆林市第二医院,陕西榆林719000

出　　处：《临床医学研究与实践》2018年第20期100-101,共2页Clinical Research and Practice

摘　　要：目的观察腹腔镜子宫切除术中等效镇痛剂量的芬太尼、舒芬太尼行全凭静脉麻时患者应激反应情况。方法选取2015年9月至2017年8月我院行腹腔镜子宫切除治疗的84例患者为研究对象,所有患者术中均行全凭静脉麻醉,并根据不同麻醉药物分为对照组(40例,给予芬太尼)、观察组(44例,给予等效镇痛剂量舒芬太尼)。比较不同时间两组患者应激反应指标水平及患者术后恢复情况。结果麻醉前、气腹前,两组的E、NE水平比较,差异不明显(P>0.05);气腹后、手术结束时,观察组E、NE水平均低于对照组(P<0.05)。观察组术后拔管镇静评分低于对照组,自主呼吸恢复时间、拔管时间、咽喉反射恢复时间均短于对照组(P<0.05)。结论腹腔镜子宫切除术全凭静脉麻醉中时使用舒芬太尼,应激反应抑制效果好、呼吸抑制轻。Objective To observe the clinical effect of the equivalent analgesia dosage of sufentanil and fentanyl on stress response in laparoscopic hysterectomy with total intravenous anesthesia.Methods A total of 84 patients with laparoscopic hysterectomy from September 2015 to August 2017 in our hospital were selected. All the patients received the intraoperative total intravenous anesthesia. The objects were divided into control group（40 cases, recieved fentanyl） and observation group（44 cases, recieved equivalent analgesic dose of sufentanil） according to the different anesthesia drugs. The levels of stress response indexes at different time and postoperative recovery conditions in the two groups were compared.Results Before anesthesia and pneumoperitoneum, the levels of E and NE in the two groups were not significantly different（P〈0.05）. At the end of the pneumoperitoneum and the surgery, the levels of E and NE in the observation group were lower than those in the control group（P〈0.05）. The postoperative sedation score after extubation in the observation group was lower than that of the control group, the spontaneous respiratory recovery time, extubation time and throat reflex recovery time were shorter than those in the control group（P〈0.05）.Conclusion Sufentanil in the laparoscopic hysterectomy with total intravenous anesthesia has great stress response inhibition effect, with slight respiratory depression.

关 键 词：舒芬太尼 全凭静脉麻醉 等效镇痛剂量 应激反应 

分 类 号：R614[医药卫生—麻醉学]