舒芬太尼复合丙泊酚或七氟醚麻醉用于胸腔镜手术的临床观察

目的：评价舒芬太尼复合丙泊酚或七氟醚麻醉在胸腔镜手术中的临床效果。方法：将42例经胸腔镜治疗自发性气胸的患者随机分为舒芬太尼复合丙泊酚静脉麻醉组（P组）和舒芬太尼复合七氟醚静吸复合麻醉组（S组）,每组21例。对比观察两种麻醉方式术中平均动脉压（MAP）和心率（HR）的变化以及术毕停药后呼之睁眼时间、自主呼吸恢复时间、拔管时间及清醒程度（采用拔管后5 min镇静评分判断）,随访术后24 h的不良反应。结果：与术前比较,两组患者插管后MAP明显低于术前（P〈0.05）,插管后2 min、摆体位后、OLV 10 min、拔管即刻两组患者MAP、HR与术前相比,差异无统计学意义（P〉0.05）;在同一时间点,组间比较差异均无统计学意义（均P〉0.05）;两组患者拔管时间、拔管后5 min镇静评分比较,差异均无统计学意义（均P〉0.05）;术后24 h,S组躁动患者明显多于P组。结论：舒芬太尼复合丙泊酚或舒芬太尼复合七氟醚用于胸腔镜手术麻醉,均能达到术后苏醒迅速、血流动力学平稳的效果,但复合丙泊酚的苏醒质量更理想。

The anesthesia efficacy of Sufentanil-Propofol or Sufentanil-Sevoflurane in patients undergoing video-assisted thoracoscopic surgery

Objective： To assess the anesthesia efficacy of Sufentanil-Propofol or Sufentanil-Sevoflurane in patients undergoing video-assisted thoracoscopic surgery（VAST）.Methods： Forty-two ASA Ⅰ-Ⅱpatients undergoing VAST were randomly divided into Sufentanil-Propofol group（group P,n=21） and Sufentanil-Sevoflurane group（group S,n=21）.MAP and HR were monitored during the entire procedures.Conscious recovery,spontaneous breathing recovery,the endotracheal extubation time,OAAS score and the side effects 24 hours after operation were recorded and compared between the two groups.Followed up the side effects 24 hours after operation.Results： Compared with before operation,MAP after intubating tube was decreased significantly in both two groups（P0.05）.Compared with before operation,the MAP and HR 2 min after intubating tube,DLV 10 min and at the time removing tube had no difference（P0.05）.There was no significant difference in conscious recovery,spontaneous breathing recovery,the endotracheal extubation time,OAAS score between the two groups at the same time point（all P0.05）.Patients with dysphoria 24 h after operation of group S were more than those of group P.Conclusion： The anesthesia efficacy of Sufentanil-Propofol or Sufentanil-Sevoflurane in patients undergoing VAST are both with quick recovery and smooth circulation.But Sufentanil-Propofol has the advantage of better palinesthesia quality than Sufentanil-Sevoflurane.