The Application Of Low-dose Sufentanil During Extubation Of Intravenous General Anesthesia With Remifentanil

Objective Explore different doses of sufentanil postoperative extubation in the remifentanil intravenous anesthesia anesthesia and cardiovascular responses to extubation during cough and restless general anesthesia wake of the performance impact, to seek the best dosageand methods.Methods elective general anesthesia for rectal cancer surgery or thyroid cancer,120cases of radical mastectomy patients, ASA I-II level, a prospective, randomized, double-blind, controlled experiment design were randomly divided into control group, R group, the experimental groupgroup S1, S2, group, and the S3group, n=30.Using the microphone alprazolam0.05mg/kg, target controlled infusion of propofol (target plasma concentration of2-4.0μg/ml) and remifentanil (target plasma concentration of-4.0ng/ml) along sulfonic acidAtracurium the0.15mg/kg induced line endotracheal intubation, the infusion along sulfonic acid atracurium (1.0to1.5μg/kg min) and remifentanil surgery to maintain.The R group of remifentanil maintained until the end of surgery, the experimental group before the end of surgery, intravenous injection of sufentanil0.10,0.15and0.20μg/kg, respectively, to the end of surgery.(Recipe: sufentanil2.5μg/kg of total100ml of surgery10minutes before the end of regular access PCIA pump, background infusion volume of3.0ml/h controlled infusion of3.0ml/30min).Stop these drugs after surgery, intravenous injection of neostigmine0.05mg/kg atropine0.015mg/kg residual role of the antagonistic muscle relaxants.Were recorded before anesthesia induction, before the push Note sufentanil and1-,3-, and5min after extubation and10min HR, BP and SpO2.Detailed annotation operation lasted, anesthesia was maintained spontaneous breathing recovery time, extubation time, after extubation, cough, restlessness, nausea and respiratory depression incidence.Recorded after surgery,6h,12h and24h, pain scores (VAS).Results lasted four groups of patients with surgery, anesthesia was maintained spontaneous breathing recovery time and the removal of the endotracheal tube time was no significant difference (P>0.05); comparison group R, S1, S2and S3group, removal of the endotracheal tube during cardiovascular responses thansmall, good after surgery,6h,12h and24h pain scores (VAS), a statistically significant difference (P<0.05); extubation cough and restlessness incidence during the R group and the group S1compared to S2and S3groups, the difference was statistically significant (P<0.05); nausea and vomiting and respiratory depression incidence S3group was higher than R, S1and S2, the difference was statistically significant (P<0.05). Conclusion sufentanil surgery extubation in the remifentanil intravenous anesthesia can effectively inhibit the extubation response and reduce post-operative pain, to obtain satisfactory results, the appropriate dose of sufentanil0.15μg/kg, complications andthe best analgesic effect.