Comparison Of Analgesic Effects Of Analgesics And Effects Of Awake Time During Gynecological Operation Under General Anesthesia

【Objective】To compare the analgesic effect of frequently used analgesics and to compare the effect of awake time under general anesthesia during gynecological operation[Methods] Eighty ASAⅠ～Ⅱpatients,ages range from 20 to 60,undergoing selective Gynecological Operation.The patients with gynecological operation were randomly separated into four groups,sufentanil group(SF),remifentanil group(R),lornoxicam group(L) and ketorolac tromethamine group(T),with 20 patients per group.Four groups of patients use the same anesthesia induction and intubated.Sustention concentrations during operation were sufentanil,remifentanil,lornoxicam,ketorolac tromethamine,propofol,isoflurane and vecuronium bromide.MAR.HR were recorded before anesthesia induction(T1),before injection of analgesic(T2),at 10min(T3),20min(T4),30min(T5) after injected with analgesic,at the end of operation(T6),before extubation(T7),at 10min(T8)after exbubation.At each point T1,T5,T7,T8 determine the rate of cortisol.Record the recovery of anesthesia each four groups[Results] Basic level of MAP,HR in four groups had no significant difference. As compared with T1 during anesthesia:MAP decreased apparently in group SF and RF at T3,T4,T5 (P<0.05).In group SF, MAP can cause a significant decrease at T6 (P<0.05),but in group RF, MAP had no significant difference at T6.In group T and group L,compare with T1,MAP had no significant difference at T4,Ts,T6.At T6,MAP of group T increased apparently (P<0.05); The comparison between four had no significant difference at T1,T3,T4,T5.At T6,compare with group SF,group RF,T,L had significant difference(P<0.05).The comparison between group RF,T,L had no significant difference. As compared with T1 during revivtication: MAP increased apparently at T7,T8 in group RF,T,L(P<0.05).Compare with group SF,MAP increased apparently in group T,L at T7(P<0.05),but had no significant difference in group RF.MAP can cause a significant increase at T8 in group RF,T,L (P<0.05). As compared with T1 during anesthesia: HR decreased apparently in group SF and RF at T3,T4,T5 (P<0.05).The comparison among four groups,HR decreased apparently at T3,T4,T5,T6 in group SF,RF (P<0.05). As compared with T1 during revivtication:HR decreased apparently at T7,T8 in group SF.In group RF,compare with T1,HR were increased obviously at T7,T8 (P<0.05).Compare with T1, HR had significant difference at T7 in group T and group L (P<0.05).Compare with group SF,HR increased obviously at T7,T8 in group RF,T,L.Copare with T1,Cor had no significant difference at T5 in four groups (P<0.05),Cor increased obviously at T7,T8 in group R,L,T (P<0.05). Intercompare the four groups,Cor increased at T7,T8 in group RF,T,L (P<0.05).Compare with group L, awake time and extubation time were extended obviously in group SF and RF(P<0.05),but the awake time and extubation time had no significant difference in group T.[Conclusio] 1.Sufentanil was the most effective analgesic on hemodynamics during gynecological operation under general anesthesia.But sufentanil had cumulative action,the awake time and extubation time were all extended.2. Ketorolac tromethamine and Lornoxicam had good analgesic effect during general anesthesia,reducing the time of recovery and extubation.