靶控输注舒芬太尼或瑞芬太尼对腹腔镜下卵巢良性肿瘤切除术患者麻醉效果及安全性的影响  

Impact of target controlled infusion of sufentanil or remifentanil on anesthetic effect and safety of patients undergoing laparoscopic resection of benign ovarian tumor

作　　者：郑平武 陈元良[1] ZHENG Ping-Wu;CHEN Yuan-Liang(Department of Anesthesiology,Jinhua Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院麻醉科,浙江金华321000

出　　处：《中国妇幼保健》2021年第6期1411-1414,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2020KY341)。

摘　　要：目的分析靶控输注舒芬太尼和靶控输注瑞芬太尼对腹腔镜下卵巢良性肿瘤切除术患者麻醉效果及安全性的影响,为临床选择麻醉药物和方法提供依据。方法选取2013年3月-2017年6月在金华市中心医院麻醉科接受全麻下腹腔镜卵巢良性肿瘤切除术的患者70例为研究对象,根据随机数字表法分为舒芬太尼靶控输注组(S组,35例)和瑞芬太尼靶控输注组(R组,35例),对比两组研究对象麻醉诱导前(T0)、麻醉诱导后(T1)、建立人工气道时(T2)、气腹时(T3)、停止气腹时(T4)、手术结束(T5)及拔管时(T6)血流动力学指数变化、术后苏醒时间及拔管时间,丙泊酚消耗量及不良反应,术后疼痛程度。结果 R组患者SBP、DBP水平在T2、T3、T6出现小幅度下降,S组患者表现为小幅度上升,S组患者在T2、T3、T6均明显高于R组(均P<0.05);两组患者HR水平在T2、T3、T6均高于基线水平,其中S组患者在T2、T6明显低于R组(均P<0.05);两组患者SPO2水平比较差异无统计学意义(P>0.05)。S组患者自主呼吸恢复时间、苏醒时间及拔管时间均长于R组(均P<0.05)。两组患者丙泊酚用量比较差异无统计学意义(P>0.05)。R组患者不良反应发生率明显高于S组(P<0.05)。R组患者各基点VAS评分在运动和静息状态时均高于S组(均P<0.05)。结论腹腔镜下卵巢良性肿瘤切除术应用靶控输注舒芬太尼或瑞芬太尼对血流动力学影响较小,瑞芬太尼易于苏醒但不良反应较多,舒芬太尼术后苏醒质量高于瑞芬太尼,且对术后镇痛有益,但是苏醒时间较长,应提前停止用药;瑞芬太尼术后苏醒快,但是常需要配合使用其他的镇痛药物。Objective To analyze the impact of target controlled infusion of sufentanil or remifentanil on anesthetic effect and safety of patients undergoing laparoscopic resection of benign ovarian tumor,provide a basis for clinical selection of anesthetic drugs and methods.Methods From March 2013 to June 2017,70 patients undergoing laparoscopic resection of benign ovarian tumor under general anesthesia in Department of Anesthesiology,Jinhua Central Hospital were selected and divided into sufentanil group and remifentanil group,35 patients in each group. The changes of hemodynamic indexes before anesthesia induction (T0),after anesthesia induction (T1),establishment of artificial airway (T2),establishment of pneumoperitoneum (T3),end of pneumoperitoneum (T4),end of surgery (T5),and extubation (T6),awakening time and extubation time after surgery,dose of propofol,and adverse reactions,the degrees of postoperative pain in the two groups were compared. Results SBP and DBP decreased slightly at the time points of T2,T3,and T6 in remifentanil group,while SBP and DBP increased slightly in sufentanil group,SBP and DBP at the time points of T2,T3,and T6 in sufentanil group were significantly higher than those in remifentanil group (P<0. 05). In the two groups,heart rates at the time points of T2,T3,and T6 were higher than the basic levels,heart rates at the time points of T2 and T6 in sufentanil group were significantly lower than those in remifentanil group (P<0. 05). There was no significant difference in SPO2 between the two groups (P>0. 05). The recovery time of autonomous respiration,awakening time,and extubation time in sufentanil group were statistically significantly longer than those in remifentanil group (P<0. 05). There was no statistically significant difference in dose of propofol between the two groups (P>0. 05). The incidence rate of adverse reactions in remifentanil group was statistically significantly higher than that in sufentanil group (P<0. 05). VAS scores at different time points under motion and rest states

关 键 词：舒芬太尼 瑞芬太尼 卵巢良性肿瘤 麻醉效果 安全性 

分 类 号：R711[医药卫生—妇产科学]