丙泊酚联合舒芬太尼在肩周炎手法松解术中的应用

摘要

目的 观察丙泊酚与舒芬太尼联合应用在肩周炎手法松解术中的效果.方法 将62例拟在静脉麻醉下行手法松解术的肩周炎患者随机分为两组,每组31例.丙泊酚组((P组)术前静脉注射丙泊酚2mg/kg,患者意识消失后开始手术,术中可静脉追加丙泊酚,每次0.5 mg/kg.丙泊酚联合舒芬太尼组(PS组)术前先采用静脉泵输人舒芬太尼0.1 μg/kg作为负荷量,然后以0.1 μg/kg/h的速度持续输注舒芬太尼,其他操作同P组.记录血压、心率、脉搏血氧饱和度、丙泊酚注射痛、术中麻醉效果分级、术后镇痛效果分级、麻醉苏醒时间、术后恶心呕吐情况.结果 PS组在术中麻醉效果及术后镇痛效果方面明显优于P组(P<0.01),且PS组未出现丙泊酚注射痛.两组在血压、心率、脉搏血氧饱和度、苏醒时间以及术后恶心、呕吐方面无显著性差异(P>0.05).结论 丙泊酚与舒芬太尼联合应用能够有效提高术中麻醉效果及术后镇痛效果.%Objective To observe the effect of propofol combined with sufentanil in manipulation release on scapulohumeral periarthritis. Methods 62 patients with scapulohumeral periarthritis undergoing manipulation release were randomly assigned to propofol group (Group P) and propofol combined with sufentanil group (Group PS) with 31 cases in each group. Group P received 2 mg/kg dose of intravenous propofol pre-operatively and Group PS received 2 mg/kg dose of intravenous propofol combined with sufentanil of which the loading dose was 0.1 μg/kg and the basal rate was 0.1 μg/kg/h pre-operatively. Repeated propofol could be used in both groups at the dose of 0.5 mg/kg. Blood pressure (BP), heart rate (HR), pulse oxygen saturation (SpO2), pain on injection of propofol, level of anesthesia effect in operation, level of analgesia after operation, recovery time, and incidence of post-operative nausea and vomiting (PONV) were recorded. Results The level of anesthesia effect in operation and the level of analgesia after operation were significantly higher in group PS (P＜0.01). No pain on injection of propofol was found in group PS. There was no significant difference in BP, HR, SpO2, recovery time, and incidence of PONV between two groups (P＞ 0.05). Conclusion Propofol combined with sufentanil can effectively improve the anesthesia effect in operation and the analgesia after operation.