宫腔镜手术中丙泊酚复合艾司氯胺酮及舒芬太尼的麻醉效果  

ANESTHETIC EFFECT OF PROPOFOL COMBINED WITH ESKETAMINE AND SUFENTANIL IN HYSTEROSCOPIC SURGERY

作　　者：闫茹冰 孙静波[2] 韩帅 史建稳[1] 褚海辰[3] 梁永新[1] YAN Rubing;SUN Jingbo;HAN Shuai;SHI Jianwen;CHU Haichen;LIANG Yongxin(Department of Anesthesia,Qingdao Women and Children’s Hospital,Qingdao University,Qingdao 266011,China)

机构地区：[1]青岛大学附属妇女儿童医院麻醉科,山东青岛266011 [2]青岛市第八人民医院基层医疗服务科 [3]青岛大学附属医院麻醉科

出　　处：《精准医学杂志》2023年第3期237-240,244,共5页Journal of Precision Medicine

基　　金：国家自然科学基金面上项目(81873729)。

摘　　要：目的 观察丙泊酚复合艾司氯胺酮及舒芬太尼静脉麻醉在宫腔镜手术中的麻醉效果。方法 选取择期行宫腔镜手术的患者90例,分为舒芬太尼联合丙泊酚组(A组)和艾司氯胺酮联合舒芬太尼和丙泊酚组(B组)。记录患者麻醉开始前(T0)、睫毛反射消失时(T1)、扩张宫颈时(T2)、手术结束时(T3)和术毕清醒时(T4)的平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO2);记录丙泊酚用量、手术时间、术后苏醒时间、术后疼痛视觉模拟评分(VAS)和Ramsay镇静评分,以及围术期不良事件的发生情况。结果 与A组相比,B组患者T1、T2、T3、T4时MAP显著升高(F=19.121~32.681,P<0.05);B组患者T1、T2时SpO2、HR显著升高(F=6.868~18.551,P<0.05);B组患者术中丙泊酚用量显著减少,术后苏醒时间明显缩短,术后Ramsay镇静评分显著降低(W=1 453.000,t=6.059、3.321,P<0.05);B组患者呼吸抑制、体动反应、低血压和窦性心动过缓发生构成比及呼吸抑制程度显著降低(χ^(2)=4.464~11.072,W=1 669.500,P<0.05)。两组患者手术时间、术后VAS评分、拟精神症状、恶心呕吐等其他不良反应发生情况比较差异无显著性(P>0.05)。结论 丙泊酚复合艾司氯胺酮及舒芬太尼静脉麻醉应用于宫腔镜手术麻醉效果理想,可有效稳定患者术中的血压、HR和SpO2,术中丙泊酚用量明显减少,患者苏醒时间明显缩短,且不良反应少,值得临床借鉴。Objective To investigate the anesthetic effect of propofol combined with esketamine and sufentanil for intravenous anesthesia in hysteroscopic surgery.Methods A total of 90 patients who underwent elective hysteroscopic surgery were divided into sufentanil+propofol group(group A)and esketamine+sufentanil+propofol group(group B).Mean arterial pressure(MAP),heart rate(HR),and pulse oxygen saturation(SpO 2)were recorded before anesthesia(T0),when eyelash reflex disappeared(T1),at cervix dilation(T2),at the end of surgery(T3),and at the time of awaking from anesthesia(T4),and the amount of propofol used,time of operation,awakening time after surgery,Visual Analog Scale(VAS)score of postoperative pain,and Ramsay sedation score were recorded,as well as the incidence rate of perioperative adverse events.Results Compared with group A,group B had a significant increase in MAP at T1,T2,T3,and T4(F=19.121-32.681,P<0.05)and significant increases in SpO 2 and HR at T1 and T2(F=6.868-18.551,P<0.05);in addition,group B had a significant reduction in the amount of propofol used during surgery,a significantly shorter postoperative awakening time,and a significant reduction in postoperative Ramsay sedation score(W=1453.000,t=6.059,3.321,P<0.05),as well as significant reductions in the composition ratio of respiratory depression,body movement,hypotension,sinus bradycardia,and the degree of respiratory depression(χ^(2)=4.464-11.072,W=1669.500,P<0.05).There were no significant differences between the two groups in time of operation,postoperative VAS score,psychotomimetic symptoms,and adverse reactions including nausea and vomiting(P>0.05).Conclusion Propofol combined with esketamine and sufentanil for intravenous anesthesia in hysteroscopic surgery has a relatively satisfactory anesthetic effect and can effectively stabilize intraoperative blood pressure,HR,and blood oxygen saturation,with a significant reduction in the amount of propofol used during surgery,a significantly shortened awakening time,and few adverse reactions,and there

关 键 词：宫腔镜检查 二异丙酚 舒芬太尼 氯胺酮 麻醉 静脉 麻醉和镇痛 

分 类 号：R71[医药卫生—妇产科学] R614.24[医药卫生—临床医学]