宫颈锥切术无阿片类药物喉罩全麻临床效果观察  

Clinical effect observation of opioid-free laryngeal mask general anesthesia during cervical conization

作　　者：马 袁红梅[1] 张素素 张瑶[1] 冯善武[1] MA Li;YUAN Hongmei;ZHANG Susu;ZHANG Yao;FENG Shanwu(Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital),Nanjing,Jiangsu Province,210004)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院),210004

出　　处：《中国计划生育学杂志》2023年第1期90-94,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨无阿片类药物喉罩全麻在宫颈锥切术中的应用效果。方法:选取2022年2月-2022年7月在本院择期行宫颈锥切术患者60例,随机数表法均分为无阿片类药物喉罩全麻组(观察组30例)、常规阿片类药物喉罩全麻组(常规组30例),比较两组麻醉诱导前(T0)、麻醉诱导后5 min(T1)、置入喉罩时(T2)、片时(T3)、拔除喉罩后5 min(T4)时平均动脉压(MAP)、心率(HR)变化,统计术中血管活性药物应用情况,术后回病房前、4 h、12 h、24 h疼痛视觉模拟评分量表(VAS)评分、不良反应、术后恢复情况。结果:与T0时相比,T1~4时观察组MAP无差异(P>0.05),T1~3时观察组HR降低(P<0.05),常规组T1~3时MAP与HR均降低(P<0.05);T1~3时观察组MAP均高于常规组(P<0.05)。两组术中均未应用乌拉地尔,术中麻黄碱使用率观察组(0例)低于常规组(23.3%)(P<0.05),阿托品使用率观察组(16.7%)与常规组(13.3%)无差异(P>0.05);两组术后各时刻疼痛VAS评分均无差异(P>0.05);观察组低血压、恶心呕吐发生率(3.3%、3.3%)低于常规组(23.3%、26.7%),定向力恢复时间(9.6±2.7min)、麻醉复苏室停留时间(21.3±6.4min)、首次肛门排气时间(8.9±2.7h)均短于常规组(20.8±4.0min、38.6±8.0min、15.8±3.5h)(均P<0.05)。结论:无阿片类药物喉罩全麻用于宫颈锥切术与常规阿片类药物麻醉效果相当,但术中循环更稳定,低血压、恶心呕吐发生率更低,术后恢复加快。Objective:To investigate the application effect of opioid-free laryngeal mask general anesthesia during cervical conization.Methods:A total of 60 patients with elective cervical conization in the hospital were selected and divided into group A(30 cases with opioid-free laryngeal mask in general anesthesia)and group B(30 cases with conventional opioid laryngeal mask in general anesthesia)by random number table metho from February 2022 to July 2022.The changes of mean arterial pressure(MAP)and heart rate(HR)of the patients before anesthesia induction(T0),5 minutes after anesthesia induction(T1),when the laryngeal mask was inserted(T2),sliced(T3),and 5 minutes after the removal of the laryngeal mask(T4)were compared between the two groups.The application of vasoactive drugs during the operation,the pain score by visual analog scale(VAS)before returning to the ward,and 4h,12h,and 24h after surgery,the adverse reactions rate,and postoperative recovery situation of the patients in the two groups were counted.Results:There was no significant difference in the MAP value of the patients in group A between T1-4 and T0(P>0.05).The HR value of the patients in group A at T1-3 was significantly lower than that at T0(P<0.05).The MAP and HR values of the patients in group B at T1-3 were significantly lower than that at T0(P<0.05).The MAP value of the patients in group A at T1-3 was significantly higher than that of the patients in group B(P<0.05).No urapidil was used in the patients in the two groups.The rate of ephedrine used(0 cases)of the patients in group A was significantly lower than that(23.3%)of the patients in group B(P<0.05).The rate of atropine used(16.7%)of the patients in group A had no significantly different from that(13.3%)of the patients in group B(P>0.05).There were no significant differences in the VAS scores of the patients at all time after surgery between the two groups(P>0.05).The incidences of hypotension,and nausea and vomiting(3.3%and 3.3%)of the patients in group A were significantly lower than those(2

关 键 词：宫颈锥切术 无阿片类药物喉罩全麻 血流动力学 麻醉药物量 不良反应 术后恢复 

分 类 号：R614[医药卫生—麻醉学]