关键词: 丙泊酚, 靶控输注, 钬激光, 舒芬太尼

Abstract: Objective To estimate the feasibility and safety of intravenous anesthesia by using target controlled infusion with propofol and sufentanil in patients undergoing ureter retrogression lithotripsy(URL) with holmium laser.Methods Thirty patients(ASA Ⅰ-Ⅱgrade),scheduled for URL,were randomly divided into two groups.All the patients received sufentanil 0.1 μg·kg^-1,3 minutes later,and then were administered by target controlled infusion of propofol.The target concentrations were 3 μg·mL^-1 in group 1(G₁,n=15)and 4 μg·mL^-1 in group 2(G₂,n=15),respectively.Operations began as soon as the effect site concentration achieved plateau.Bispectral Index(BIS) was controlled under 60 by propofol bolus delevery.In addition,when the operation was disturbed because of body movement,a few dosage of propofol would be delevered.Mask positive pressure ventilation was applied when pulse oxygen saturation(SpO₂) was lower than 90%.Blood pressure,heart rate,SpO₂ and BIS value were monitored.Other parameters such as sedation grade(RAMSAY),complications,total dosage and frequency of propofol bolus injection,time for recovery would also be compared between the two groups.Results The sedation grades of the two groups were both 4-5.BIS were 59±10 and 56±13,and there were no statistical difference between G₁ and G₂ groups.The incidence of mask ventilation were 2/15 in G₁ and 8/15 in G₂(χ²:P=0.02)respectively;the incidence of body movement were 5/15 in G₁ and 1/15 in G₂(χ²:P=0.08);time to open eyes with command was(2.8±1.1)minutes in G₁ and(8.3±3.0)minutes in G₂;time for recovery of directional judgment was(7.6±1.9)minutes in G1 and(15.6±2.2)minutes in G₂;total dosage of propofol given were(225.5±77.7)mg in G₁ and(342.5±72.6)mg in G₂;all of the 5 parameters mentioned above were statistically different between the two groups(P<0.01).Each patient had no memory during the operation.Conclusion The combined anesthesia of propofol and sufentanil in two groups are both good for URL,whereas there was less side-effects in the group with target concentration of 3 μg·mL^-1 than the other.

Key words: target-controlled infusion, propofol, holmium laser, sufentanil