【摘要】 目的比较等效剂量的舒芬太尼与芬太尼用于脊柱侧凸矫形手术麻醉中对术中唤醒试验及术后恢复情况的影响。方法ASAⅠ~Ⅱ级脊柱侧凸后路矫形手术患者40例,随机分为F组(n=20)和S组(n=20)。所有患者均异氟醚低流量吸入(1L/min,O2∶N2O=1∶1)维持麻醉。F组芬太尼1~1·5μg/kg间断静脉注入维持镇痛,唤醒试验前总量不超过5μg/kg;S组舒芬太尼0·1~0·2μg/(kg·h)持续泵注入维持镇痛,唤醒试验前总量不超过1μg/kg。记录术中血流动力学变化、呼气末异氟醚浓度(ETiso)以及唤醒时间和术后清醒拔管时间等。结果两组唤醒时间、术后清醒拔管时间、唤醒试验期间呛咳、躁动发生率及术后吗啡用量、PONV发生率无差异。结论舒芬太尼合理使用不会延长术中唤醒试验的时间,可以安全用于脊柱侧凸矫形手术。更多还原

【Abstract】 Objective To compare the effects of equivalent dose of sufentanil and fentanyl on wake-up test and recovery profile in scoliosis surgery. Methods Forty ASAⅠ-Ⅱadolescents undergoing scoliosis surgery were randomly divided into fentanyl group (group F,n=20) and sufentanil group(group S,n=20). Anesthesia was maintained with low-flow(1 L/min) inhalation of isoflurane and nitrous oxide (O2∶N2O=1∶1) in both groups. Intermittent i.v. boluses (1～1.5 μg/kg) of fentanyl was used for analgesia in group F, and total dosage was not more than 5μg/kg when the wake-up test was started. Continuous infusion of sufentanil [0.1～0.2 μg/(kg·h)] was maintained in group S, and total dosage was less than 1 μg/kg when the wake-up test was started. The wake-up test time, postoperative recovery time, end-tidal isoflurane concentration(ETiso) and other hemodynamic variables during operation were recorded. Results There was no significant difference in the wake-up test time, postoperative recovery time, bucking and/or restlessness during the wake-up test, PCA morphine dosage and PONV between the two groups. Conclusion Properly administration of sufentanil does not prolong the intraoperative wake-up test time so that it can safely be used in scoliosis surgery.更多还原