舒芬太尼联合丙泊酚全凭静脉麻醉用于胸科手术的临床观察

目的:探讨舒芬太尼联合丙泊酚全凭静脉麻醉用于胸科手术的麻醉效果。方法:选取行胸科手术患者60例,按照随机数字法分为观察组和对照组各30例。对照组给予传统的静吸复合全身麻醉;观察组给予舒芬太尼0.5～1.5 μg·kg-1·h-1联合丙泊酚3～5 mg·kg-1·h-1静脉持续泵注,肌松维持均为阿曲库铵0.6 μg·kg-1·min-1静脉泵注;对比2组患者的麻醉效果及不良反应。结果:2组T1心率均较T0明显下降(P<0.01),且对照组的T2～T5的心率均显著高于观察组(P<0.01);对照组T1较T0的收缩压(SBP)值明显下降,观察组T3较T0的SBP值亦显著下降(P<0.01),对照组T2～T5的SBP值均明显高于观察组(P<0.01);2组T4 SpO₂均较T0明显升高(P<0.01),对照组T3 SpO₂值显著高于观察组(P<0.01)。对照组拔管时间为(18.3±7.8)min,明显长于观察组的(12.8±6.9)min(P<0.01);术后对照组总不良反应率30.0%,高于观察组的6.7%(P<0.05)。观察组苏醒期配合率为93.3%,高于对照组的80.0%(P<0.05)。结论:舒芬太尼联合丙泊酚全凭静脉麻醉用于胸科手术麻醉效果好,术后清醒快且不良反应发生率低,值得临床推广使用。

Clinical observation of sufentanil combined with propofol total intravenous anesthesia for the chest surgery anesthesia

Objective:To discuss the anesthesia effects of using sufentanil combined with propofol total intravenous anesthesia. Methods:Sixty patients with thoracic surgery were chosen and divided into two groups according to the random number method ( 30 cases in each group ):the control group was given the traditional intravenous anesthesia;the observation group was given sufentanil 0. 5~1. 5 μg· kg-1 · h-1 combined with propofol 3 ~5 mg · kg-1 · h-1 venous continuous pump and 0. 6 g · kg-1 · min-1 of atracurium was used to keep muscle relaxan. The anesthesia effects and complications of the two groups were recorded and compared. Results:Heart rate of the two groups was declined at T1 compared with T0,and results showed that heart rate of the control group was higher than that of the observation group(P<0. 01) from T2 to T5;systolic blood pressure(SBP) values of the control group were decreased at T1 compared with T0 while SBP values of the observation group were decreased at T3 compared with T0,and SBP values of the control group from T2 to T5 were higher than those of the observation group(P<0. 01);at T4 SpO2 values of the two group were higher than at T0,SpO2 values of and the control group were higher than that of the observation group(P<0. 01). In the control group the extubation time was(18. 3 ± 7. 8) min,significantly longer than that in the observation group(12. 8 ± 6. 9) min(P <0. 01);Postoperative adverse reaction rate of the control group was 30. 0% higher than that of the observation group 6. 7%(P <0. 05). Awakening period match rate in the observation group was 93. 3% higher than that in the control group 80. 0% (P <0. 05). Conclusions:Using sufentanil combined with propofol has better anesthesia effects,also with shorter postoperative awake time and low incidence of adverse reactions,which is worthy of clinical promotion.