妇科腹腔镜手术应用瑞芬太尼和舒芬太尼苏醒质量的比较

发布时间：2018-01-01 07:11

本文关键词：妇科腹腔镜手术应用瑞芬太尼和舒芬太尼苏醒质量的比较　出处：《华北理工大学学报(医学版)》2016年05期 　论文类型：期刊论文

【摘要】：①目的比较瑞芬太尼和舒芬太尼应用于妇科腹腔镜手术患者术后苏醒质量的差异。②方法妇科腹腔镜手术患者70例,分为瑞芬太尼组(R组)和舒芬太尼组(S组),各35例。全麻诱导:R组和S组分别推注瑞芬太尼1.5μg/kg和舒芬太尼0.4μg/kg,同时推注咪达唑仑0.05mg/kg、苯磺顺阿曲库铵0.15mg/kg、丙泊酚2mg/kg。术中R组和S组分别以瑞芬太尼0.2μg/(kg·min)和舒芬太尼0.5μg/(kg·h)经推注泵注射,所有患者术中复合吸入1.5%~2.0%七氟醚维持麻醉,关气腹时停止所有麻醉药物。记录患者麻醉停药后自主呼吸恢复时间、睁眼时间、指令反应恢复时间、拔除气管导管时间;统计患者围拔管期并发症及不良反应发生情况;评定患者拔管后30分钟的Ramsay清醒评分;对患者拔管后5分钟、30分钟、1小时和3小时进行疼痛评分(VAS)。③结果 S组患者各项苏醒指标比R组略长,但差异无统计学意义(P0.05);R组患者术后躁动的发生率高于S组(P0.05)。与R组相比,S组Ramsay评级为1的患者明显偏少(P0.05);S组患者在拔管后5分钟、30分钟、1小时的VAS评分均比R组低,差异有统计学意义(P0.05);两组患者围拔管期各种不良反应发生率均较低,舒芬太尼组有1例发生呼吸抑制。④结论舒芬太尼和瑞芬太尼均可使患者快速安全苏醒,术后不良反应发生率均较低。舒芬太尼在降低拔管后切口疼痛、躁动的发生率方面优于瑞芬太尼,但需注意术后呼吸抑制。
[Abstract]:Objective to compare the remifentanil and sufentanil in different recovery quality after gynecologic laparoscopic surgery. Methods the patients undergoing gynecologic laparoscopic surgery in 70 cases, divided into remifentanil group (group R) and sufentanil group (S group), 35 cases in each. The induction of general anesthesia: R group and S group were injected remifentanil 1.5 g/kg and sufentanil 0.4 g/kg, and bolus of midazolam 0.05mg/kg, cisatracurium besilate 0.15mg/kg, propofol 2mg/kg. operation in R group and S group respectively with remifentanil 0.2 g/ (kg - min) and sufentanil 0.5 g/ (kg - H) by injection pump injection, the patients in combined inhalation 1.5%~2.0% sevoflurane anesthesia, stop all anesthetic drugs off pneumoperitoneum after discontinuation of anesthesia were recorded. The recovery time of spontaneous breathing, eye opening time, command response recovery time, extubation time; statistical extubation in patients of complications and the incidence of adverse reactions; The Ramsay score of 30 minutes of awake patients were assessed after extubation; 5 minutes after extubation in 30 minutes, 1 hours and 3 hours of pain score (VAS). The patients in the S group the recovery index slightly longer than the R group, but the difference was not statistically significant (P0.05); R group of patients with postoperative agitation the incidence is higher than that of S group (P0.05). Compared with R group, S group, Ramsay rating of 1 patients significantly decreased (P0.05); patients in group S after extubation in 5 minutes, 30 minutes, 1 hours of VAS were lower than R group, there was statistically significant difference between the two groups (P0.05); extubation in patients of various adverse reaction rates were low, 1 cases of respiratory depression occurred in sufentanil group. Conclusion sufentanil and Reventa Ni can make rapid patient safety recovery, postoperative adverse reaction rate was lower. After extubation of sufentanil in reducing the incision pain, the incidence of agitation is better than Reventa Ni, but need to pay attention to postoperative call Absorption inhibition.

【作者单位】：南通大学附属海安医院麻醉科;
【分类号】：R614
【正文快照】： 腹腔镜手术由于操作方便、手术创伤小、术后康复快、手术并发症少等优点,现已广泛开展。而二氧化碳气腹及患者体位的改变会对患者的呼吸循环功能造成明显影响[1],需要有效的麻醉药物抑制手术时机体产生的各种应激,维持内环境的稳定。本研究以适宜剂量的瑞芬太尼和舒芬太尼分别

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