阿芬太尼联合瑞马唑仑用于宫腔镜无痛诊疗的临床效果  

Clinical effect of alfentanil combined with remazolam in painless hysteroscopic treatment

作　　者：朱宏宇[1] 吴志林[1] 刘焕 孙燕[1] 陈向东 ZHU Hongyu;WU Zhilin;LIU Huan;SUN Yan;CHEN Xiangdong(Department of Anesthesiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,湖北武汉430022

出　　处：《西部医学》2022年第8期1209-1212,1217,共5页Medical Journal of West China

摘　　要：目的观察阿芬太尼联合不同剂量瑞马唑仑用于宫腔镜诊疗时的临床效果。方法选择2021年1月~2021年2月于我院无痛宫腔镜诊疗患者60例,ASAⅠ或Ⅱ级,随机分为两组,每组30例。R1组:阿芬太尼10μg/kg+瑞马唑仑0.15 mg/kg静注,R2组:阿芬太尼10μg/kg+瑞马唑仑0.2 mg/kg静注,待患者睫毛反射消失后开始宫腔镜诊疗,如单次剂量达不到镇静要求,视情况追加瑞马唑仑2.5 mg/次。记录麻醉诱导前、给药后3 min和扩张宫颈时的血压(BP)、心率(HR)、脉氧饱和度(SpO_(2))、呼吸频率(RR)。比较两组诱导时间、苏醒时间、术中体动次数、不良反应、术后宫缩痛的发生率和患者满意度。结果与R1组相比,R2组诱导时间缩短,扩张宫颈时平均动脉压和心率的变化较小(P<0.05),术中体动次数明显减少(P<0.05);两组术中不良反应、苏醒时间、术后宫缩痛的发生率和患者满意度比较差异无统计学意义(P>0.05)。结论阿芬太尼10μg/kg联合瑞马唑仑0.2 mg/kg使用对宫腔镜诊疗患者作用时间短,不良反应少,对循环和呼吸影响轻微,可为宫腔镜无痛诊疗提供较为良好的镇静镇痛效果。Objective To observe the effectiveness and safety of alfentanil combined with different doses of remazolam for painless hysteroscopic treatment.Methods Sixty patients undegoing painless hysteroscopic treatment from January 2021 to February 2021 were randomly allocated into the two groups with 30 cases in each group.Alfentanil 10μg/kg+remazolam 0.15mg/kg was used in Group R1 and alfantanil 10μg/kg+remazolam 0.2mg/kg was used in Group R2.Hysteroscopic treatment began after the patient's eyelash reflex disappeared.If a single dose of remazolam did not meet the sedation requirements,2.5 mg of remazolam was added at the appropriate time.Patients'blood pressure(BP),heart rate(HR),pulse oxygen saturation(SpO_(2)) and respiratory frequency(RR)before anesthesia,3min after induction and the time point of cervical dilation were recorded.The time spending for induction and awakening,intra-operative body movements,adverse reactions,incidence of uterine contraction pain and the patient's satisfaction in the two groups were also compared.Results Patients in Group R2 had shorter induction time,smaller changes in BP and HR(P<0.05),and less intraoperative movements than patients in Group R1(P<0.05).There was no statistical difference in awakening time and departure time,adverse reactions incidence of uterine contraction pain and patient satisfaction between the two groups.Conclusion Afentanyl 10μg/kg combined with remazolam 0.2mg/kg can be effectively used in painless hysteroscopic treatment.

关 键 词：瑞马唑仑 阿芬太尼 宫腔镜检查 无痛诊疗 

分 类 号：R614[医药卫生—麻醉学] R713.4[医药卫生—外科学]