Objective To discuss the efficacy of sufentanil and propofol by target-controlled infusion (TCI) for intubation, extubation, postoperative analgesia and adverse reactions and recovery after laparoscopic ovarian cystectomy. Methods Forty-one adult patients ( ASA Ⅰ - Ⅱ ) scheduled for laparoscopic ovarian cystectomy were enrolled into the study. They were allocated to TCI sufentanil (effect-site concentration 0.4 μg/L) group (S group, n =21) or TCI remifentanyl (effect-site concentration 4 μg/L) group (R group, n =20). The plasma concentration of propofol was 4 mg/L in both the groups. The hemodynamics during intubation and extubation, including systolic and diastolic pressure and heart rate, as postoperative pain, analgesia and side effects were compared between the two groups. Results The systolic and diastolic pressure at intubation and extubation between the two groups were statistically significant different, but the difference is clinically acceptable. Compared to R group, S group had less cases of atropine use [0% (0/21) vs. 60.0% (12/20), P=0.000]. The mean time for eyes opening [ (25. 69 ± 12. 97) min vs (10.68±2.67) min, t =5.073, P =0.000] and birth date recalling [(27.25 ±13.21) min vs. (13.30 ±1.61) min, t =4.801, P= 0.000] in S group were significant longer than those in R group. Whereas, S group showed significantly lower the VAS scales in 2 hours postoperatively, less use of diclofenac sodium, and lower rate of vomiting than R group [ P = 0. 000; 0% (0/21 ) vs. 55. 0% (11/20), P=0.000; and 14.3% (3/21) vs. 45.0% (9/20),x2 =4.668, P=0.031, respectively]. Conclusions For laparoscopic ovarian cystectomy, sufentanil TCI (effect-site concentration 0. 4 μg/L) combined with propofol shows hemodynamic stability during intubation and extubation with less inhibitory effect on heart rate. Its postoperative analgesic effect is persistent and satisfying without needing any other postoperative analgesics or side effects. Sufentanil TCI should be stopped 15 to 20 minutes before the anticipated end of surgery.%目的 探讨腹腔镜卵巢囊肿剔除术中靶控输注舒芬太尼复合丙泊酚对麻醉诱导气管插管、气管拔管和术后疼痛的影响. 方法 41例ASA I～Ⅱ级择期全麻下行腹腔镜卵巢囊肿剔除手术患者,随机分为舒芬太尼组(S组,n=21)和瑞芬太尼组(R组,n=20).麻醉诱导时设定舒芬太尼和瑞芬太尼效应室浓度分别为0.4 μg/L和4μg/L；丙泊酚血浆浓度均为4 mg/L.观察麻醉诱导插管、拔管时血流动力学变化,包括收缩压、舒张压、心率变化；追踪术后疼痛、辅助镇痛治疗及不良反应的发生情况. 结果 2组气管插管、拔除导管时,收缩压与舒张压比较有统计学意义,但与基础值比较波动未超过30％,在临床可接受范围.S组阿托品使用明显少于R组[0％ (0/21) vs.60.0％ (12/20),P=0.000].在麻醉恢复期,S组呼之睁眼[(25.69±12.97)min vs.(10.68±2.67)min,t=5.073,P=0.000]和准确说出生日的时间[(27.25±13.21)minvs.(13.30±l.61)min,t=4.801,P=0.000]明显比R组延长,但术后2h内S组疼痛视觉模拟评分(VAS)显著低于R组(P =0.000)；S组双氯芬酸钾使用明显少于R组[0％ (0/21)vs.55.0％(11/20),P=0.000]；S组术后恶心呕吐发生率明显少于R组[14.3％ (3/21) vs.45.0％ (9/20),x2=4.668,P=0.031)]. 结论 靶控输注舒芬太尼(效应室浓度0.4 μg/L)复合丙泊酚用于妇科腹腔镜下卵巢囊肿剔除术,在麻醉诱导插管和拔管时血流动力学稳定,对心率的抑制作用较轻,并可产生持续、理想的术后镇痛效果,无需补充其他镇痛药,副作用小,但建议手术结束前15～20 min停药.
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