摘要
目的:观察3种剂量舒芬太尼复合丙泊酚在宫腔镜手术中的麻醉效果和安全性。方法:随机数字表法将本院2018年6月—2020年6月收治的99例择期宫腔镜手术患者分为I组、II组和III组各33例,行宫腔镜手术时分别给予舒芬太尼0.15μg/kg、0.20μg/kg、0.25μg/kg静脉注射,均给予2.0mg/kg丙泊酚镇静。比较麻醉效果,以及麻醉前(T0)、扩张宫颈时(T1)、手术中(T2)、手术结束时(T3)及术后苏醒时(T4)心率(HR)、血氧饱和度(SpO2)、平均动脉压(MAP),手术麻醉过程不良反应。结果:II组、III组麻醉起效时间无差异但低于I组,患者术后意识恢复时间、丙泊酚用量I组、II组、III组依次升高(P<0.05)。术后1hRamsay评分与VAS评分3组无差异(P>0.05)。HR、MAP、SpO2,3组T1、T2、T3时均低于T0时(P<0.05);I组T1、T2、T3、T4时无差异(P>0.05),T1时HR III组低于I组、II组,MAP II组、III组低于I组,SpO2 II组低于I组(P<0.05):T2时HR II组、III组低于I组,MAP III组低于I组、II组,SpO2 II组低于I、III组(P<0.05);T3时HR III组低于I组、II组,MAP II组、III组低于I组,SpO2 III组低于I组(P<0.05)。不良反应发生率I组、II组、III组(12.1%、15.2%、18.2%)无差异(P>0.05)。结论:采用0.15μg/kg舒芬太尼联合丙泊酚用于宫腔镜手术对患者血流动力学波动影响较小,苏醒迅速,术后镇痛镇静效果显著,且能减少丙泊酚使用量,麻醉安全有效,值得临床应用借鉴。
Objective:To observe the anesthesia effect and safety of three dosages of sufentanil combined with propofol during hysteroscopic surgery.Methods:99 patients who wanted elective hysteroscopic surgery were selected and were divided in three groups(33 cases in each group)by random number table method from June 2018 to June 2020.All these patients were given 2.0mg/kg propofol for sedation.And the patients in group I,II,and III were also given intravenous injection of sufentanil 0.15ug/kg,0.20ug/kg,and 0.25ug/kg,respectively.The anesthesia effects,the values of the hemodynamic indexes,such as heart rate(HR),blood oxygen saturation(SpO2),and mean arterial pressure(MAP)before anesthesia(T0),when the cervix dilated(T1),during the operation(T2),in the end of the operation(T3),and when awake after the operation(T4),and the rate of adverse reactions during surgical anesthesia of the patients were compared among the three groups.Results:The anesthesia work time of the patients had no significant different between group II and group III,but which was significant shorter than that of the patients in group I.The time of postoperative consciousness recovery and the dosage of propofol of the patients in group I,II,III had increased gradually(P<0.05).There were no significant different in postoperative 1h Ramsay score and VAS score of the patients among the three groups(P>0.05).The values of HR,MAP,and SpO2 of the patients in the three groups at T1,T2 and T3 were significant lower than those at T0(P<0.05).There were no significant different in the values of HR,MAP,and SpO2 of the patients among T1,T2,T3,T4(P>0.05).At T1,the HR value of the patients in group III was significant lower than that of the patients in group I and II,the MAP value of the patients in group II and III was significant lower than that of the patients in group I,and the SpO2 value of the patients in group II was significant lower than that of the patients in group I(P<0.05).At T2,the HR value of the patients in group II and III was significant lower than that of the patients in group I,the MAP value of the patients in group II and III was significant lower than that of the patients in group I and III,and the SpO2 value of the patients in group II was significant lower than that of the patients in group I and III(P<0.05).At T3,the HR value of the patients in group III was significant lower than that of the patients in group I and II,the MAP value of the patients in group II and III was significant lower than that of the patients in group I,and the SpO2 value of the patients in group III was significant lower than that of the patients in group I(P<0.05).There were no significant different in the incidence of adverse reactions(12.1%vs.15.2%vs.18.2%)among the three groups(P>0.05).Conclusion:0.15ug/kg sufentanil combined with propofol used during hysteroscopic surgery of the patients has little effect on their hemodynamic change,which has advantages of awaken up quickly and significant postoperative analgesic and sedative effect with less dosage of propofol,and which is worthy of clinical application because of its safety and effectiveness of anesthesia.
作者
蒲梅婷
甘怀玉
解翔彬
吴小颖
PU Meiting;GAN Huaiyu;XIE Xiangbin;WU Xiaoying(Sanya People's Hospital, Sanya, Hainan Province, 572000)
出处
《中国计划生育学杂志》
2021年第9期1864-1867,1872,共5页
Chinese Journal of Family Planning
