舒芬太尼及瑞芬太尼分别复合异丙酚用于静脉麻醉临床探究.docVIP

舒芬太尼及瑞芬太尼分别复合异丙酚用于静脉麻醉临床探究【摘要】目的：比较舒芬太尼与瑞芬太尼分别复合异丙酚用于静脉麻醉的临床效果。方法：选择ASAⅠ-Ⅱ级、择期行腹腔镜辅助下阴式子宫切除术（LAVH）病人40 例，随机分为舒芬太尼组(SF)和瑞芬太尼组(R)，每组20例。分别采用舒芬太尼和瑞芬太尼为主诱导和维持麻醉，观察两组病人麻醉诱导及维持期血流动力学变化和苏醒期相关时间、质量以及术后疼痛情况。结果：舒芬太尼组麻醉术中循环较稳定，苏醒亦快，术后疼痛程度轻。结论：舒芬太尼复合异丙酚用于静脉麻醉比瑞芬太尼更优越、安全，苏醒质量更优良。 【关键词】静脉麻醉；瑞芬太尼；舒芬太尼；术后疼痛 文章编号：1009-5519（2007）18-2700-02 中图分类号：R614 文献标识码：A Clinical study of sufentanil and remifentanil combined with propofol respectively for intravenous anesthesia HUANG Xiao-ling，HUANG Dong (The Third Xiangya Hospital of Zhongnan University，Changsha 410013，China) 【Abstract】Objective：To compare the clinical effect of sufentanil and remifentanil combined with propofol respectively for intravenous anesthesia.Methods:Forty ASA Ⅰ-Ⅱ patients scheduled for laparoscopic assisted vaginal hysterectomy(LAVH),were randomly divided into two groups,with 20 cases in each group.The SF group was given sufentanil combined with propofol for the induced anesthesia and maintenance anesthesia,while the R group with remifentanil and propofol in the same way as the SF group.The items observed were hemodynamics during induction and maintenance,analepsia time,the quality of recovery from anesthesia and postoperative pain.Results:The SF group had more stabler perioperative hemodynamics,quick analepsia and less postoperative pain compared with those in the R group. Conclusion:Sufentanil combined with propofol was more safe and effective for intravenous anesthesia,which was superior to remifentanil and propofol. 【Key words】Intravenous anesthesia；Remifentanil；Sufentanil；Postoperative pain 舒芬太尼是一种新合成的强效拟吗啡类长效镇痛药，临床上目前主要用于较长时间的手术及术后镇痛等；瑞芬太尼亦是一种新型的阿片类受体激动剂，具有起效迅速，药效强，作用消失快，无蓄积作用等优点。我们观察了舒芬太尼与瑞芬太尼复合异丙酚用于腹腔镜辅助下阴式子宫切除手术麻醉的临床效果并作了比较，现报道如下： 1 资料与方法 1.1 病例选择：ASAⅠ～Ⅱ级，择期行腹腔镜辅助下阴式子宫切除术病人40例，采用随机表法分为舒芬太尼组(SF)和瑞芬太尼组（R），两组病人的年龄、体重、基础血压、心率等指标的差异均无显著性(均P0.05)。 1.2 研究方法：病人入手术室前半小时肌肉注射鲁米那钠100 mg、阿托品 0.5 mg，入手术室后开放静脉，常规监测三导联心电图、脉搏血氧饱和度、无创血压(袖带)，记录基础血压和心率，纯氧吸入3分钟后开始麻醉诱导，SF组：麻醉诱导以丙泊酚2 mg/kg、舒芬太尼0.7 ?滋