微创医学

目的探讨舒芬太尼和瑞芬太尼用于妇科手术复合全麻时脑电双频指数（BIS）、收缩压、舒张压和呼吸值变化情况，以期提高麻醉安全性。方法以150例妇科全麻手术患者为研究对象，分成A、B 2组各75例，分别予瑞芬太尼（A组）和舒芬太尼（B组）加基础麻醉药物，观察BIS、SBP、DBP、HR值和相关指标上变化情况。结果 T0和T1、T2、T3、T4、T5、T6在BIS、SBP、DBP和HR上比较，两组差异均有统计学意义（P＜0.05）；而T1和T2、T3在DBP和HR上比较，两组差异有统计学意义（P＜0.05），T1和T2、T3在瑞芬太尼SBP上比较，差异有统计学意义（P＜0.05）；T1和T3在舒芬太尼SBP上比较，差异有统计学意义（P＜0.05）。另外在呼吸恢复时间、苏醒睁眼时间、气管拔管时间、定向力恢复时间、镇痛药物所需时间比较，差异有统计学意义（P＜0.05）。结论瑞芬太尼和舒芬太尼在妇科手术全麻诱导下均能抑制气管插管所造成的应激反应，但舒芬太尼对血压搏动影响性低，维持循环系统更稳定。

Objective To explore the influence of sufentanil and remifentanil on BIS, SBP, DBP and HR value during gynecological surgery anesthesia. Methods From May 2010 May 2013, 150 cases receiving gynecological surgery anesthesia were divided into two groups, 75 cases in each group. A group was given sufentanil, while B group was given remifentani. BIS, SBP, DBP, and HR values were recorded. Results T0 and T1, T2, T3, T4, T5, T6 at the BIS, SBP, DBP and HR were significant different(P＜0.05); and T1 and T2, T3 at the DBP and HR were significant different (P＜0.05), T1 and T2, T3, in the remifentanil group, SBP had statistically significant difference (P＜0.05); T1 and T3 in the sufentanil group, SBP difference was statistically significant (P＜0.05). There were difference in the breathing recovery time, recovery time of eye opening, tracheal extubation time, orientation recovery time, and the time required to give the analgesic drugs (P＜0.05). Conclusion Both sufentanil and remifentanil anesthesia in gynecologic surgery can inhibit the stress response induced by tracheal intubation, and sufentanil can maintain circulation stabilization due to less impact on blood pressure.