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目的比较舒芬太尼联合瑞芬太尼与芬太尼联合瑞芬太尼用于脊柱侧弯矫形手术麻醉对术中唤醒试验的影响。方法选择ASAⅠ～Ⅱ级脊柱侧凸后路矫形手术患者40例,随机分为2组,每组20例。Ⅰ组用舒芬太尼1μg/kg诱导。Ⅱ组用芬太尼5μg/kg诱导,2组术中吸入七氟醚及笑气,持续静脉泵入瑞芬太尼维持麻醉。记录唤醒时间,呼气末七氟醚浓度(ETsev),唤醒期间血流动力学变化以及唤醒期躁动呛咳例数等。结果两组唤醒期间血液动力学变化无显著性差异。Ⅰ组患者唤醒时间为(8.5±1.2)min短于Ⅱ组的(12.3±2.4)min,P﹤0.05;唤醒期间呛咳躁动发生率I组为10%,明显低于Ⅱ组的40%(P﹤0.05)。结论舒芬太尼联合瑞芬太尼应用于脊柱侧弯手术唤醒试验中能够缩短唤醒时间,唤醒质量高,更适用于脊柱手术。
Objective To compare the effects of sufentanil combined with remifentanil and fentanyl in combination with remifentanil on the awakening test during orthopedic surgery for scoliosis. Methods Forty ASA Ⅰ ~ Ⅱ grade posterior correction orthopedic surgery patients were randomly divided into two groups (n = 20 in each group). Group Ⅰ sufentanil 1μg / kg induced. Group Ⅱ was induced with 5μg / kg of fentanyl, and two groups were given sevoflurane and nitrous oxide during continuous intraoperative infusion of remifentanil to maintain anesthesia. The wake-up time, end-expiratory sevoflurane concentration (ETsev), hemodynamic changes during awakening, and the number of restless cough during awakening were recorded. Results There was no significant difference in hemodynamic changes between the two groups during awakening. The wake time in group Ⅰ was (8.5 ± 1.2) min shorter than that in group Ⅱ (12.3 ± 2.4) min, P <0.05. The incidence of cholecystokinia was 10% in group I during awakening, significantly lower than that in group Ⅱ 40% P <0.05). Conclusion The combination of sufentanil and remifentanil can shorten the awakening time and improve the quality of wakefulness in spinal surgery. It is more suitable for spinal surgery.