舒芬太尼与瑞芬太尼分别复合丙泊酚对小儿麻醉诱导期血压和脑电双频指数的影响比较

目的:探讨舒芬太尼复合丙泊酚与瑞芬太尼复合丙泊酚两种麻醉方案的优劣。方法:以2016年3月至2017年3月在我院进行择期全麻手术的患儿150例作为研究对象,根据进行全麻手术的时间先后编号,采用随机数表法分为舒芬太尼组和瑞芬太尼组各75例。舒芬太尼组患儿采用舒芬太尼复合丙泊酚进行全麻,瑞芬太尼组患儿采用瑞芬太尼复合丙泊酚进行全麻。观察并比较两组患儿在麻醉诱导期诱导前(T1)、静脉注射舒(瑞)芬太尼后(T2)、静脉注射丙泊酚后(T3)、插管即刻(T4)、插管后2 min(T5)、5 min(T6)]的收缩压(SAP)、舒张压(DBP)、平均动脉压(MAP)和脑电双频指数(BIS)。结果:舒芬太尼组患儿在T4时的DBP、MAP均优于瑞芬太尼组(P均<0.05);两组患儿在各时间点的BIS比较差异无统计学意义(P均>0.05)。舒芬太尼组患儿自主呼吸恢复、肢体动作恢复和拔管时间均短于瑞芬太尼组(P<0.05);呼吸抑制、苏醒期躁动、恶心呕吐和意识障碍发生情况均少于瑞芬太尼组(P<0.05)。结论:与瑞芬太尼复合丙泊酚相比,舒芬太尼复合丙泊酚能够显著改善患儿的术后疼痛,同时呼吸抑制等副作用较小,在需要进行全麻手术的患儿中应用具有明显优势。

Sufentanil and Remifentanil Respectively Combined with Propofol on Blood Pressure and Bispectral Index in Children during Anesthesia Induction

Objective: To investigate the advantages and disadvantages of sufentanil and remifentanil respectively combined with propofol. Methods: A total of 150 children undergoing general anesthesia surgery in our hospital from Mar. 2016 to Mar. 2017 were extracted, according to the serial number of general anesthesia surgery, all children were divided into the sufentanil group and the remifentanil group via the random number table, with 75 cases in each group. The sufentanil group received general anesthesia with sufentanil and propofol, while the remifentanil group was given general anesthesia with remifentanil and propofol. Systolic blood pressure (SAP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and bispectral index (BIS) of two groups were observed and compared during anesthesia induction period such as before induction (T1), after intravenous injection of sufentanil (remifentanil) (T2), after intravenous injection of propofol (T3), intubation (T4), after intubation of 2 min (T5) and after intubation of 5 min (T6). Results: The DBP and MAP in the sufentanil group were better than those in the remifentanil group at T4 (P<0.05). There was no significant difference in BIS between two groups at each time point (P>0.05). The spontaneous respiratory recovery, limb movement recovery and extubation time of the sufentanil group were shorter than those of the remifentanil group (P<0.05), the respiratory depression, restlessness, nausea and vomiting, and disturbance of consciousness were less than those in the remifentanil group (P<0.05). Conclusion: Compared with remifentanil, sufentanil combined with propofol can significantly improve the postoperative pain of children, meanwhile, the side effects such as respiratory depression are less. Therefore, the application of sufentanil combined with propofol has obvious advantages in children undergoing general anesthesia surgery.