舒芬太尼与瑞芬太尼复合丙泊酚用于肝肿瘤经皮微波凝固麻醉的研究

目的研究舒芬太尼或瑞芬太尼复合丙泊酚全凭静脉麻醉下肝肿瘤经皮微波凝固治疗对患者循环功能、呼吸、复苏质量及术后疼痛等方面的影响。方法肝肿瘤患者40例,随机分成两组,舒芬太尼组（S组,n=20）,瑞芬太尼组（R组,n=26）。S组舒芬太尼0.2μg/kg诱导,0.10.2μg/（kg·h）维持;R组瑞芬太尼1μg/kg诱导,0.10.2μg/（kg·m in）维持。两组均复合使用丙泊酚：诱导1.0mg/kg,维持3.06.0 mg/（kg·h）。记录麻醉诱导前、麻醉诱导后5 min、治疗开始后5 min、停药后5 min的血流动力学变化。术毕病人Ramesay镇静评分、VAS评分及病人总体满意度。结果S组患者术中、术后血流动力学无明显差异,满意度高。R组患者用药后HR、SBP、DBP下降明显（P〈0.01）,术毕疼痛发生率高,满意度低。结论舒芬太尼配伍丙泊酚术中血流动力学稳定,术后有良好的镇静、镇痛,病人满意度高。

Study of Sufentanil or Remifentanil Combined with Propofol in Percutaneous Microwave Coagulation Therapy for Hepatic Tumor

Objective To study the hemodynamic variation,resuscitation quality,and the satisfaction of patients in total intravenous anesthesia（TIVA）.Methods Forty patients undergoing percutaneous microwave coagulation therapy（PMCT） for malignant hepatic tumor were divided into sufentanil group（Group S,n=20） and remifentanil group（Group R,n=20）.Drugs for induction were propofol（1.0 mg/kg）,sufentanil（0.2 μg/kg）（Group S） or remifentanil（1 μg/kg）（Group R）.Anesthesia was maintained by propofol 3.0-5.0 mg/kg·h,sufentanil 0.1-0.2 μg/kg·h（Group S） or remifentanil 0.1-0.2 μg/kg·min（Group R）.SBP,DBP,HR,RR and SpO2 were recorded.Thirty minutes after therapy,the resuscitation quality and the satisfaction of the patients were recorded.Results In Group R,SBP,DBP,HR and RR were lower 5 min after induction and 5 min after starting of operation（P〈0.01）.The quality for resuscitation,as well as the satisfaction of patients was also lower（P〈0.01）.Conclusion Sufentanil combined with propofol provides a better anesthesia with stable hemodynamics,high resuscitation quality and high satisfaction for PMCT.