舒芬太尼在无痛胃镜手术中的应用

目的探讨舒芬太尼复合丙泊酚在无痛胃镜检查中的可行性和安全性。方法择期无痛胃镜手术80例，随机分成舒芬太尼组（S组）和芬太尼组（F组），每组40例，分别采用舒芬太尼0．1μg／kg或芬太尼1μg／kg复合丙泊酚行静脉全麻。记录两组患者麻醉前（T0）、置镜后5min（T1）、手术结束时（T2）的MAP、HR、SPO2、手术时间、麻醉药物用量、苏醒时间、体动以及血压下降、低氧血症、心动过缓等术中并发症的发生率。结果两组在手术结束时的HR、MAP低于麻醉前（P〈0．05）；S组置镜后5minHR、MAP低于F组（P〈0．05）；S组苏醒时间、丙泊酚的总用量均低于F组（P〈0．05）；S组术中并发症、术后不良反应较F组少。结论舒芬太尼复合丙泊酚在无痛胃镜检查中能有效抑制机体的应激反应，呼吸抑制轻，比芬太尼能更好地满足门诊无痛胃镜检查的需要，更具优势。

Application of sufentanil in painless gastroscopy

Objective To discuss the feasibility and safety of applying sufentanil combined with propofol in painless gastroscopy. Methods 80 patients receiving selective painless gastroscopy were selected and randomly assigned to sufentanil group （Group S） and f-entanyl group （Group F） with 40 cases in each group. The two groups were given intravenous anesthesia by 0.1 μg/kg sufentanil or 1μg/kg fentanyl combined with propofol. MAP, HR, SpO2, operation duration, amount of narcotic drugs, recovery time, body movement and the incidence of decreased blood pressure, hypoxemia, bradycardia and other intraoperative complications before anesthesia（T0）, 5 minutes after painless gastroscopy （T1）, after surgery（T2） were recorded for the two groups. Results The two groups had lower HR and MAP after surgery than before anesthesia （P 〈 0.05）. Group S had lower HR and MAP than group F at 5min after painless gastroscopy （P 〈 0.05）. Group S had shorter recovery time and less amount of propofol than Group F （P 〈 0.05）. Group S had fewer complications and postoperative adverse reactions than Group F. Conclusion Sufentanil combined with propofol can effectively inhibit stress reaction in painless gastroseopy with mild respiratory depression, which better satisfies the needs of painless gastroscopy in outpatient service than fentanyl with distinctive advantages.