摘要
目的探讨舒芬太尼复合异丙酚麻醉在妇科腹腔镜手术老年患者中的应用效果。方法按随机数字表法将60例妇科腹腔镜手术老年患者分为舒芬太尼组与瑞芬太尼组,每组30例。舒芬太尼、瑞芬太尼初始靶效应室浓度分别为0.25ng/ml、2ng/ml,均复合初始血浆靶浓度为2μg/ml的异丙酚,每2min增加0.5μg/ml,直至意识消失。比较两组血流动力学变化、麻醉情况、苏醒时间、术后镇痛效果及并发症。结果两组SBP、DBP和HR在T1、T2和T5时有统计学意义(P<0.05);两组麻醉时间、意识消失时间、意识消失时异丙酚剂量和异丙酚总剂量无统计学意义(P>0.05);舒芬太尼组自主呼吸恢复时间、呼之睁眼时间、拔管时间和定向力恢复时间均明显长于瑞芬太尼组(P<0.05);舒芬太尼组VAS评分显著高于瑞芬太尼组(P<0.05),OAA/S评分无统计学意义(P>0.05),镇痛药使用率及并发症发生率均明显少于瑞芬太尼组(P<0.05)。结论与瑞芬太尼相比,舒芬太尼复合异丙酚麻醉用于妇科腹腔镜手术老年患者,血流动力学更加平稳,术后苏醒质量更优,并发症更少,值得临床推广应用。
Objective To study the clinical effect of sufentanil and pmpofol combined anesthesia in gynecological laparo- scopic surgery With elderly patients. Methods Sixty elderly patients with laparoscopic surgery were randomized to the sufentanil group and the remifentani group, 30 patients per group. The initial target effective concentrations in the sufentanil group and the remifentani group were iespectively 0. 25ng/ml and 2ng/ml and were composite with the initial target plasma concentration of 2μg/ ml propofol. The 0. 5μg/ml was increased every two minutes until loss of consciousness. The hemodynamic changes, anesthesia condition, recovery time, postoperative analgesia effect and complications were compared in the two groups. Results During the T1 .T2 and T5 phases, the SBP, DBP and HR in the two groups were obviously difference （ P 〈 0. 05 ） ; In the anesthesia time, time, propefol dose at the loss of consciousness and the total dose of propefol, the difference was not found in the two groups （P 〉 0. 05 ）; Compared with the remifentani group, the spontaneous breathing recovery time, the eye-opening time, extubation time and orientation recovery time in the sufentanil group were obviously prolonged （ P 〈 0. 05 ） ; Compared with the /emifentani group, the VAS scores were obviously increased （P 〈 0. 05 ） and the OAA/S scores were not obviously difference in the two groups （P 〉 0. 05） ; Compared with the remifentani group, the ratio of analgesic usage and incidence of complications in the sufentanil group were obviously decreaseed （P 〈 0. 05）. Conclusion Compared with the remifentani group, the sufentanil and propofol combined anesthesia in gynecological laparoscopic surgery with elderly patients was able to stabilize the hemodynam- ics, improve the quality of postoperative recovery, decrease the complications and worthy of clinical application.
出处
《四川医学》
CAS
2012年第12期2109-2111,共3页
Sichuan Medical Journal
关键词
妇科腹腔镜
舒芬太尼
瑞芬太尼
异丙酚
麻醉
gynecological laparoseopy
sufentanil
remifentani
propofol
anesthesia
