| 摘要: |
| ［摘要］ 目的 比较舒芬太尼与芬太尼在腹腔镜胆囊切除术（LC）全凭静脉麻醉中的插管和苏醒期的反应。方法 选择拟行腹腔镜胆囊切除术的患者60例（男27例，女33例），ASA Ⅰ～Ⅱ级，年龄35～60(41.2±6.8）岁，体重45～70(61.5±5.9）kg，随机分成舒芬太尼组（S组）和芬太尼组（F组），每组30例。S组术中使用舒芬太尼0.3 μg/(kg·h)泵入，F组术中使用芬太尼2 μg/(kg·h)静脉注射。两组均以丙泊酚6～8 mg/(kg·h)恒速泵入维持麻醉。手术结束前30 min停止舒芬太尼或芬太尼，结束前10 min停止丙泊酚输注。记录:(1)诱导前、诱导后、插管前、插管时的血压和心率；(2)丙泊酚的使用总量、苏醒时间、拔管时间、术后意识恢复评分；(3)术后疼痛的评分。结果 (1)诱导前后的血压和心率变化幅度S组小于F组，插管前后的血压、心率变化也较F组小，差异有统计学显著意义（P<0.05）；插管时的呛咳反应发生的比例较F组低，但差异无统计学意义；(2)丙泊酚的使用总量、苏醒时间、拔管时间、术后意识恢复评分两组比较差异均有统计学极显著意义(P<0.01）；(3)术后疼痛的评分S组较F组低。结论 舒芬太尼可以安全有效地应用于LC的全凭静脉麻醉，并且麻醉苏醒更平稳。 |
| 关键词: 舒芬太尼 芬太尼 全凭静脉麻醉 腹腔镜胆囊切除术 |
| DOI：10.3969/j.issn.1674-3806.2009.10.21 |
| 分类号:R 657.4 |
| 基金项目: |
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| Comparison of total intravenous anaesthesia with propofol-sufentanil versus propofol-fentanyl in laparoscopic cholecystectomy |
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BI Jing-bin, XIE Wei-nong
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Department of Anesthesiology, Chaohu Second People′s Hospital, Anhui 238000, China
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| Abstract: |
| ［Abstract］ Objective To compare the reactions of induction and analepsia period between TIVA with propofol-sufentanil and TIVA with propofol-fentanyl in laparoscopic cholecystectomy.Methods Sixty ASAⅠ-Ⅱpatients (27male, 33female) aged 35～60（41.2±6.8）years, weighed 45～70(61.5±5.9)kg, undergoing laparoscopic cholecystectomy were divided randomly into group sufentanil (S, n=30) and group fentanyl (F, n=30), group S receive sufentanil 0.3 μg/(kg·h), group F receive fentanyl 2μg/(kg·h), which was stopped at 30 min before the end of operation. Each group given propofol 6 mg/(kg·h), which was stopped at 10 min before the end of operation. Two groups were given PCIA. The following data were recorded and compared between the two groups:（1）The changes in BP and HR during tracheal intubation and induction; (2) Consumption of propofol, analepsia and extubation time, consciousness recovery and (3)VAS in postoperation.Results （1）During tracheal intubation and induction the changes of BP and HR were significantly greater in group F than that in group S（P<0.05）； (2) Consumption of propofol was less in group S than that in group F(P<0.01)； （3）Analepsia and extubation time in group S was faster than those in group F(P<0.01)； （4）Consciousness recovery and VAS after operation were significantly better in group S. Conclusion TIVA with propofol-sufentanil suits to laparoscopic cholecystectomy and recovery from anesthesia with propofol-sufentanil is faster and stabler than that with propofol-fentanyl. |
| Key words: Sufentanil Fentanyl Total Intravenous Anaesthesia(TIVA) Laparoscopic cholecystectomy |
