中文摘要：

目的评价不同剂量舒芬太尼对靶控输注丙泊酚和瑞芬太尼麻醉下行腹腔镜胆囊切除术后苏醒质量的影响。方法选取拟行腹腔镜胆囊切除术的患者150例，根据随机数字表法分为5组（每组30例）：舒芬太尼0．1μg／kg组（F1组）、0．2μg／kg组（F2组）、0．3μg／kg组（F3组）、0．4μg／kg组（F4组）和等容量生理盐水组（N组），所有患者采用Narcotrend监测下靶控输注丙泊酚和瑞芬太尼的麻醉方法，常规监测心电图（ECG）、无创血压（BP）、心率（HR）、血氧饱和度（SpO2）、呼末二氧化碳分压（PETCO2），在手术结束前10min分别于F1组、F2组、F3组、F4组和N组给予0．1、0．2、0．3、0．4μg／kg的舒芬太尼和等剂量的生理盐水。观察并记录术毕即刻（T0）、术毕10min（T1）、拔管前1min（T2）、拔管即刻（T3）、拔管后5min（T4）、10min（T5）平均动脉压（MAP）和心率（HR）。记录患者自主呼吸恢复时间、苏醒时间和拔管时间。分别于拔管后10、30、60min和4h进行视觉模拟疼痛评分（VAS评分）。记录苏醒期躁动、嗜睡和呼吸抑制等麻醉并发症。结果与R相比，N组、F1组于T1-5时MAP升高，HR增快（P〈0．05），分别与N组、F1组相比，F2组、F3组和F4组于T1-5时MAP下降，HR减慢（P〈O．05），F3组和F4组的呼吸恢复时间、苏醒时间和拔管时间均较N组、F1组和F2组延长（P〈O．05），F2组、F3组和F4组术后早期的VAS评分较N组和F1组低（P〈0．05），N组和F1组术后出现苏醒期燥烦的发生率较高，而F3组和F4组术后出现嗜睡和呼吸抑制的发生率较高。结论在静脉麻醉下行腹腔镜胆囊切除术结束前10min给予0．2μg／kg舒芬太尼可有效地改善患者术后复苏质量。

英文摘要：

Objective To evluate effects on recovery quality of different doses of sufentanil combined with propofol and remifentanil by TCI for patients in laparoscopic choleeystectomy. Methods One thoudred and fifty patients scheduled for laparoscopic eholeeystectomy were divided into 5 groups randomly according to random digits table （n=30）： sufentanil 0.1 μg/kg （group F1）, 0.2 μg/kg （group F2）, 0.3 μg/kg （group F3）, 0.4 μg/kg （group F4）, the same volume of NS （group N）. ECG, BP, heart rate （HR）, SpO2 and PETCO2 were monitored during the operation. Anesthesia was induced and maintained with propofol and remifentanil by TCI in all patients. 10 min before the end of operation, different doses of sufentanil were given through vein to the correspond groups while group N was given the same volume of NS. Mean arterial pressure （MAP） and HR were measured 0 min （T0）, 10 min （T1） after surgery, 1 min before extubation（T2） , 0 min （T3）,5 min （T4） , 10 min （T5） after extubation. Extubation time, the recovery of spontaneous breathing time, recovery time were measured, visual analogue scale （VAS） was recorded 10, 30, 60 min and 4 h after extubation. The complications of anesthesia were observed and recorded during recovery, including restlessness, respiratory depression and lethargy, et al. Results Compared with To, MAP, HR increased in group N and group F1 at T1-5 （P〈 0.05）. Compared with group N and group F1 respectively, group F2, group F3 and group F4 had lower MAP, HR （P〈0.05）. Extubation time, the recovery of spontaneous breathing time and recovery time were longer in group F3 and group F4 （P〈0.05）. Postoperative early VAS scores were lower in group F2, group F3 and group F4 （P〈0.05）. The complications were less in group F2. Conclusions Sufentanil 0.2 ~g/kg given through vein 10 min before the end of operation is the dose of choice for patients undergoing laparoscopic cholecystectomy with total intravenous anesthesia and might ameliorate re