盐酸氢吗啡酮应用于妇科宫腔镜检查术的临床观察  

Clinical Observation of Hydromorphone in Hysteroscopy Operation

作　　者：文立红[1] 肖晓山[1] 梁飞[1] 李俊[1] 

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《现代医院》2017年第2期264-266,共3页Modern Hospitals

基　　金：广东省年度适宜卫生技术推广项目(编号:粤卫[2010]152号)

摘　　要：目的探讨盐酸氢吗啡酮用于妇科宫腔镜检查术的临床效果及安全性。方法将择期妇科宫腔镜检查术患者60例随机分为盐酸氢吗啡酮组(H组)和舒芬太尼组(S组)各30例。开始麻醉前30 min,两组均经静脉注射盐酸戊乙奎醚0.01 mg/kg。H组静脉注射盐酸氢吗啡酮0.01 mg/kg+丙泊酚2.0 mg/kg;S组静脉注射舒芬太尼0.15μg/kg+丙泊酚2.0 mg/kg;记录麻醉前(t_1)、喉罩置入时(t_2)、扩张宫颈时(t_3)、手术结束拔出喉罩时(t_4)心率和血压的变化。观察患者拔出喉罩后在恢复室观察期间患者发生恶心呕吐、呼吸抑制及嗜睡的情况。记录两组患者拔管时间、恢复室停留时间。结果两组组间比较,在同一时间点的血压和心率比较无统计学意义(P>0.05);两组组内比较,患者在t_2、t_3时间点的心率血压与t_1时间点的心率血压比较,均有所下降且具有统计学意义(P<0.05);H组出现呕吐、呼吸抑制、嗜睡的发生率均低于S组(P<0.05)。H组在恢复室停留时间要少于S组恢复室停留时间。结论盐酸氢吗啡酮用于妇科宫腔镜检查术中镇痛作用与舒芬太尼相当,且术后不良反应少。Objective To investigate the feasibility and safety of hydromorphone in hysteroscopy operation. Meth- ods Sixty patients undergoing hysteroscopy were randomly divided into two groups （with 30 patients in each group） ： hydro- morphone group （ group H） and sufentanil group （ group S）. 30 minutes before anesthesia, patients of the two groups were administered intravenously penehyelidine hydrochloride 0. 01 mg/kg. Patients of the group H gave the intravenous of hydro- morphone 0. 01 mg/kg and propofol 2. 0 mg/kg; Patients of the group S gave the intravenous of sufentanil 0. 15 p^g/kg and propofol 2. 0 mg/kg; The HR and MAP were recorded at the time of before anesthesia （ tI ） , at the time of placing a laryngeal （t2 ） ,at the time of cervical dilatation （t3 ） , at the time of extubation （t4 ）. The occurrence of adverse effects such as nausea, vomiting, respiratory depression and drowsiness were recorded during postanesthesia care unit after operation. The time of during postanesthesia and extubation time were record. Results There were no statistically significant differences in the blood pressure and heart rate at same time point between two groups （ P 〉 0. 05 ）. In two groups, the blood pressure and heart rate at t2 and t3 was lower than that at tI （P 〈 0. 05 ）. The incidence of nausea, vomiting, respiratory depression and drowsi- ness in the sufentanil group is higher than that in the hydromorphone group （ P 〈 0. 05 ）. The time of during postanesthesia of group H was less than that of group S. Conclusion The analgesia effect of hydromorphone in hysteroscopy operation corre- sponds to sufentanil, and the side effects may be less in postoperstion.

关 键 词：盐酸氢吗啡酮 舒芬太尼 恶心呕吐 呼吸抑制 宫腔镜检 

分 类 号：R971.2[医药卫生—药品] R443.8[医药卫生—药学]