纳布啡复合依托咪酯用于宫腔镜手术的麻醉效果观察  

Effects of Nalbuphine Combined with Etomidate for Hysteroscopy:A Contrast Study

作　　者：邹军[1] 赵子然 尹小清 ZOU Jun;ZHAO Zi-ran;YIN Xiao-qing(Department of Anesthesiology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120

出　　处：《岭南急诊医学杂志》2021年第4期373-375,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:观察和对比宫腔镜术中使用纳布啡复合依托咪酯或复合使用丙泊酚的麻醉效果。方法:自2020年7月至2021年3月,共入组我院收治的45名拟择期宫腔镜手术患者,随机分为对照组(丙泊酚组,P组,n=23)和试验组(依托咪酯组,E组,n=22)。两组均在手术前对患者静脉滴注0.2 mg/kg纳布啡,E组给予依托咪酯0.2-0.3 mg/kg/h持续泵注,P组给予丙泊酚2-3μg/ml靶控输注。待睫毛反射消失后开始手术。比较两组患者麻醉前5 min(T0)、扩宫时(T1)、手术开始5分钟(T2)和苏醒时(T3)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO_(2))变化情况,比较两组手术时长和苏醒时间,记录两组呼吸抑制、注射痛、体动次数、术后恶心呕吐、肌震颤等不良反应情况。结果:两组患者的手术时长无显著差异,P组苏醒时间较E组长(P<0.05);术中两组HR、MAP、SpO_(2)均呈现先降低后升高的情况(P<0.05);E组的HR、MAP、SpO_(2)值均高于P组(P<0.05);随着时间延长,与E组相比,P组HR、MAP和SPO_(2)的波动更大。E组术中呼吸抑制、注射痛等不良反应发生率明显低于P组(P<0.05),两组诱导期肌震颤、术中体动次数、术后恶心呕吐发生率无显著差异(P>0.05)。结论:与丙泊酚复合纳布啡相比,依托咪酯联合纳布啡用于短小宫腔镜手术麻醉,镇静镇痛效果确切,且呼吸循环更稳定,苏醒质量更高。Objective:To compare the effects of etomidate and propofol combined with nalbuphine for hysteroscopy.Methods:A total of 45 patients undergoing hysteroscopy were randomized into group P(propofol combined with nalbuphine group,n=23)and group E(etomidate combined with nalbuphine group,n=22). Both groups were given 0.2 mg/kg nalbuphine by slow intravenous injection before operation. Group E was given etomidate 0.2-0.3 mg/kg/h by continuous-pumping infusion,and group P was given propofol 2-3 μg/mL by target-controlled infusion. The operation began after the eyelash reflex disappeared. The mean arterial blood pressure(MAP),heart rate(HR)and SpO_(2) were recorded before anesthesia(T0),uterine dilation(T1),5 min after the beginning of surgery(T2),and after recovery(T3). The operative duration,recovery time,Respiratory depression,injection pain,serious body movement,postoperative nausea and vomiting,muscle tremor and other adverse reactions were also recorded. Results:There was no significant difference in operation time between the two groups(P>0.05),The recovery time of group P was longer than that of group E(P<0.05). HR,MAP and SpO_(2) were firstly decreased and then increased(P<0.05);HR,MAP and SpO_(2) in group E were higher than those in group P(P<0.05);HR,MAP and SpO_(2) fluctuated more in group P over time. The incidence of respiratory depression and injection pain in group E was significantly lower than that in group (P<0.05),There were no significant differences in body movement,postoperative nausea and vomiting,muscle tremor between the two groups(P>0.05). Conclusion:Compared with propofol combined with nalbuphine,etomidate combined with nalbuphine for hysteroscopy plays definite sedative and analgesic effects,more stable respiratory and circulation,and better recovery quality.

关 键 词：依托咪酯 纳布啡 丙泊酚 宫腔镜 

分 类 号：R614[医药卫生—麻醉学]