The Application Of Propofol Combined With Sufentanil Anesthesia In Hysteroscopy Ambulatory Surgery

Objective: To observe the effect of propofol target-controlled infusion (TCI) alone with propofol TCI combine with sufentanil in the hysteroscope Ambulatory Surgery. Discuss the safety and effectiveness anesthetize with propofol target-controlled infusion (TCI) combine with sufentanil in the hysteroscope Ambulatory Surgery, by evaluating the respiration circulation infection, the depth of anesthesia, recovery results and complications.Methods: Twenty ASAⅠorⅡambulatory patients for painless hysteroscope operation, were divided into two groups: propofol group (P group) and sufentanil group (S group), according to random number list. Before operation patients were given the same volume of physiological saline or sufentanil (0.1μg/kg) by a fixed nurse, who didn't participate anesthesia, surgery or postoperative care. The operater was another fixed doctor. Patients were monitored by ECG HR SBP DBP RR SpO2 and BIS, face mask oxygen was gaven conventionally by six L/min. Open vein fluid path and connect to the propofol target-controlled pump. Input the patient information into the pump control, such as gender, age, height and weight, and set the target-controlled plasma concentration of 5μg/ml. 5-minute before pumping propofol inject intravenous of physiological saline (P group) or sufentanil (0.1μg/kg, S group) slowly, more than 60 seconds, and then start target-controlled infusion pump, when the value of BIS reduced to below 60 start the operation, stop the punp immediately at the end of the operation. Take the flowing four time: before anesthesia and immediately after induction of anesthesia, surgery beginning, at the end of operation, record the heart rate (HR),systolic blood pressure (SBP), diastolic blood pressure (DBP),mean arterial pressure (MBP), respiratory rate (RR), pulse Oxygen saturation (SpO2) and BIS value. Record operation time, the time when the eyes opened at her name, orientation recovery time (the time from the end of operation to answering simple questions correctly), the total amount of propofol were aslo observed and recorded. Observe respiratory inhibition and body movements during the operation, Evaluate postoperative pain by the VAS score at the waking time, 15 minutes, 30 minutes and 60 minutes after the operation.Result: The general situation of the patients (such as age, height, weight and body mass index), and operation time in two groups had no significant different. Patients in two groups were stable in respiration and circulation, Except of the heart rate at the beginning of the operation ( T2) and the end of operation ( T3) S group were lower than P group, the difference had statistically significant (P < 0.05),.The two groups during the surgery the vital signs (heart rate, blood pressure, mean pulse oxygen saturation) showd no statistically significant difference. The effect of anesthetia in the S group was better than the P group, The depth of anesthesia: BIS value (45.40±9.94) of the S group at T2 is lower than the P group (57.20±7.86), the difference had statistically significant (P <0.01); the lowest BIS value during the surgery in the S group (35.10±6.79) was lower than the P group (45.60±6.31), the difference had statistically significant (P < 0.01); body movements in the S group (20%) was fewer than the P group (80%); the difference had significant (P < 0.05). Anesthesia recovery of eyes opening time in the P group (3.90±1.79min) was shorter than the S group (5.00±2.75min) , orientation recovery time of the P group (5.00±2.00min) was shorter than the S group (95.40±3.24min) , but these differences had no statistically significant (P > 0.05). Comparing the recovery and postoperative complications , the S group patients had lower VAS score of abdominal pain than the P group patients, the difference had statistically significant (P < 0.05 ), Two of the S group patients had postoperative nausea, but no vomiting, meanwhile the P group had none, but the difference had no statistically significant (P> 0.05). Conclusion: 1 Propofol as a sedative is commonly used in ambulatory surgery, to short-time and less pain surgery propofol can achieve good results, but when comes to intensity stimulation surgery, more amount of propofol is needed but side-effects can't be avoid.2 Target-controlled infusion of propofol combined with sufentanil is safe and effective anesthesia method for ambulatory surgery.3 Small dose of sufentanil (0.1μg/kg) combined with propofol for ambulatory surgery does not increase the risk of respiratory inhibition and the incidence of postoperative nausea and vomiting.