摘要
目的:比较芬太尼或舒芬太尼复合丙泊酚全身麻醉用于宫腔镜通液术时的丙泊酚用量、清醒时间、麻醉效果、不良反应及对认知功能的影响。方法:择期行宫腔镜通液术的患者48例,ASAⅠ～Ⅱ级,不用术前用药,随机分为芬太尼复合组和舒芬太尼复合组,每组24例,分别予芬太尼0.001mg/kg或舒芬太尼0.1μg/kg复合丙泊酚2.5mg/kg行麻醉诱导。手术期间脑电双频指数(BIS)维持在40～50。分别记录患者的丙泊酚用量、术毕停药后清醒时间、术中有无体动、术后有无恶心呕吐。分别在术前及术后5min、15min、1h、24h应用简易智能状态检查(MMES)评定患者的认知功能。结果:舒芬太尼复合组的丙泊酚用量显著少于芬太尼复合组(P<0.01),清醒时间显著短于芬太尼复合组(P<0.01)。5min、15min舒芬太尼复合组MMES评分高于芬太尼复合组,1h、24h差异无统计学意义。两组术中体动及恶心、呕吐差异无统计学意义。两组间术中体动及术后恶心呕吐的差异无统计学意义(P>0.05)。芬太尼复合组和舒芬太尼复合组术后5min和15min的MMES评分均显著低于术前(P<0.01),两组1h、24h的MMES评分与该组术前的MMES评分比较无明显降低(P<0.05)。两组间术前、术后1h和24h的MMSE评分的差异无统计学意义(P>0.05),舒芬太尼复合组术后5min和15min的MMES评分显著高于芬太尼复合组(P<0.01)。术后5min舒芬太尼复合组5例、芬太尼复合组14例患者的认知功能下降(MMES评分下降≥2分,P<0.05),15min舒芬太尼复合组2例、芬太尼复合组9例患者的认知功能下降(P<0.05)。术后1h芬太尼复合组有1例患者有认知功能下降,舒芬太尼复合组无患者有认知功能下降。结论:与芬太尼复合丙泊酚相比,舒芬太尼复合丙泊酚用于宫腔镜通液术全身麻醉时丙泊酚的用量少,术后清醒快,术后认知功能下降的发生率低。
Objective:Compare the effection about the dose of propofol,sober time,anesthetic effects,adverse reactions and cognitive function in Fentanyl or sufentanil combined with propofol general anesthesia for Hysteroscopic tubal surgery.Methods:Elective Hysteroscopic tubal surgery 48 patients,ASA Ⅰ～Ⅱ,Without premedication,randomly divided into the fentanyl group and sufentanil group,24 cases in each group,anesthesia was induced:fentanyl 0.001mg/kg or sufentanyl 0.1μg/kg and propofol 2.5mg/kg,the bispectral index(BIS)is maintained at 40 to 50 during the Surgery.respectively record:dose of propofol,awake time after discontinuation of surgery,with or without body movement during the surgery,with or without nausea and vomiting after surgery.Applications Mini Mental State Examination(MMES)assessment of the patient's cognitive function at preoperative,5min,15min,1h and 24h after the operation.Result The dose of propofol Sufentanil group was significantly less than the fentanyl group(P<0.01),awake time was significantly shorter than fentanyl group(P <0.01).5min,15min sufentanyl group MMES scores higher than the fentanyl group.1h,24h no statistical difference.Body movement,nausea and vomiting in the two groups of patients no statistical difference.MMES scores were significantly lower than the preoperative both of the fentanyl group and the the sufentanil group at postoperative 5min and 15min(P <0.01).Compared the MMES scores with preoperative and postoperative was no significantly reduced in each group at 1h and 24h.Between the two groups the MMES scores was not statistically significant at preoperative,5min,15min,1h and 24h after the operation.MMES scores of Sufentanil group was significantly higher than the of fentanyl composite group at postoperative 5min and 15min(P<0.01).5 patients's cognitive function reduced in sufentanil group and 14 patients' in fentanyl group at postoperative 5min(MMES score decreased ≥ 2 points,P <0.05).2 patients's cognitive function reduced in sufentanil group and 9 patients'cognitive function reduced in fentanyl group at postoperative 15min.Fentanyl group 1 patients with cognitive function decline and sufentanil group no patient with cognitive function decline.Conclusion:Compared with fentanyl combined with propofol and sufentanil combined with propofol general anesthesia for Hysteroscopic tubal surgery,Sufentanil combined with propofol for general anesthesia with Small dose of propofol,fast of postoperative awake,Low incidence of postoperative cognitive decline.
出处
《北方药学》
2013年第6期98-99,58,共3页
Journal of North Pharmacy
关键词
全身麻醉
认知功能
宫腔镜
舒芬太尼
芬太尼
General Anesthesia Cognitive Function Postoperative、Hysteroscopy Sufentanil Fentanyl
