酒石酸布托菲诺和舒芬太尼应用于显微喉镜手术的麻醉效果比较  

Comparison of the effects of butorphanol tartrate and sufentanil in micro-laryngoscope surgery

作　　者：李潺 李杰 贾继娥 LI Chan;LI Jie;JIA Ji-e(Department of Anesthesiology,Eye Ear Nose and Throat Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院麻醉科

出　　处：《复旦学报（医学版）》2019年第3期394-398,共5页Fudan University Journal of Medical Sciences

摘　　要：目的比较酒石酸布托菲诺和舒芬太尼应用于显微喉镜手术的麻醉效果。方法选取86例择期行显微喉镜手术的患者,ASAⅠ-Ⅱ级,年龄18~65岁,随机分为酒石酸布托菲诺组(N组,n=43)和舒芬太尼组(S组,n=43)。两组患者麻醉诱导均给予丙泊酚2mg/kg+琥珀胆碱1.5mg/kg+瑞芬太尼1.5μg/kg;外科悬吊喉镜前N组患者给予酒石酸布托菲诺0.02mg/kg,S组给予舒芬太尼0.1μg/kg,术中麻醉维持采用七氟烷1.3MAC+瑞芬太尼微量泵输注。记录患者围术期生命体征变化;记录苏醒期拔管时间、镇静-躁动评分和拔管时呛咳评分;记录术后咽痛评分,恶心呕吐、头晕、嗜睡、肌痛等不良反应。结果两组患者围术期生命体征、苏醒期拔管时间、苏醒期镇静-躁动评分、拔管时呛咳评分和术后咽痛评分差异无统计学意义(P>0.05);但N组术后3h头晕发生率高于S组(P<0.05),术后3h和8h嗜睡发生率也高于S组(P<0.05)。结论酒石酸布托菲诺和舒芬太尼均可为显微喉镜手术麻醉提供良好的镇痛,但使用酒石酸布托菲诺术后短时间内伴有轻微头晕和嗜睡现象。Objective To compare the anesthetic effects of butorphanol tartrate injection and sufentanil on micro-laryngoscope surgery. Methods Eighty-six patients aged 18-65 with ASA grade Ⅰ-Ⅱ undergoing selective micro-laryngoscopy surgery were randomly divided into two groups:butorphanol group (group N, n =43) and sufentanil group (group S, n =43).For induction,both groups were given propofol 2 mg/kg,succinylcholine 1.5 mg/kg and remifentanil 1.5 μg/kg.Group N was given butorphanol tartrate 0.02 mg/kg before suspension of laryngoscope while group S received sufentanil 0.1 μg /kg.Intraoperative anesthesia was maintained with sevoflurane 1.3 MAC and remifentanil micropump infusion.The perioperative changes of vital signs,extubation time,Sedation-Agitation score,cough score immediately after exubation,postoperative pharyngalgia score and incidence of adverse reactions including nausea,vomiting,dizziness,drowsiness,myalgia were recorded. Results There were no significant differences in perioperative vital signs,extubation time,Sedation-Agitation score, cough score and pharyngalgia score post operation between the two groups ( P > 0.05 ). The incidence of dizziness in group N 3 hours after operation was higher than that in group S ( P < 0.05 ).The incidence of drowsiness in group N 3 hours and 8 hours after operation was higher than that in group S ( P <0.05). Conclusions Both butorphanol tartrate and sufentanil could provide favorable analgesia for micro-laryngoscopic surgery.Butofenol tartrate may lead to slight dizziness and drowsiness in a short time after operation.

关 键 词：酒石酸布托菲诺 舒芬太尼 显微喉镜手术 

分 类 号：R614[医药卫生—麻醉学]