艾司氯胺酮与瑞芬太尼复合丙泊酚在门诊无痛宫腔镜检查中的应用效果比较  

Comparison of the application effect of esketamine and remifentanil combined with propofol in outpatient painless hysteroscopy examination

作　　者：陈方[1] 白宁[1] 路凯[1] 刘静[1] 岳芳 CHEN Fang;BAI Ning;LU Kai;LIU Jing;YUE Fang(Anesthesiology Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院麻醉科,陕西西安710068

出　　处：《临床医学研究与实践》2024年第3期29-32,共4页Clinical Research and Practice

基　　金：陕西省自然科学基础研究计划项目(No.2019JQ-975)。

摘　　要：目的比较艾司氯胺酮与瑞芬太尼复合丙泊酚在门诊无痛宫腔镜检查中的应用效果。方法选择陕西省人民医院2021年10月至11月自愿接受无痛宫腔镜检查的60例患者作为研究对象,根据随机数字表法将其分为A组和B组,每组30例。A组静脉推注艾司氯胺酮0.5 mg/kg、丙泊酚1.5 mg/kg,B组静脉推注瑞芬太尼0.5μg/kg、丙泊酚1.5 mg/kg。记录两组围术期呼吸抑制、低血压、恶心呕吐、体动反应发生情况;记录两组苏醒时间、丙泊酚使用量及术后10、30 min数字模拟评分法(NRS)评分;比较两组的患者满意度及手术医生满意度评分。结果A组的呼吸抑制、低血压发生率显著低于B组,差异具有统计学意义(P<0.05);两组的恶心呕吐、体动反应发生率比较,差异无统计学意义(P>0.05)。两组的苏醒时间比较,差异无统计学意义(P>0.05);A组的丙泊酚使用量显著少于B组,术后10、30 min的NRS评分显著低于B组,差异具有统计学意义(P<0.05)。两组的患者及手术医生满意度评分比较,差异无统计学意义(P>0.05)。结论相比于瑞芬太尼复合丙泊酚,艾司氯胺酮复合丙泊酚在门诊无痛宫腔镜检查中的麻醉效果满意,术中不良反应少,术后疼痛程度轻,值得临床推广与应用。Objective To compare the application effect of esketamine and remifentanil combined with propofol in outpatients painless hysteroscopy examination.Methods A total of 60 patients who voluntarily received painless hysteroscopy examination in Shaanxi Provincial People's Hospital from October to November 2021 were selected as the research objects.According to the random number table method,the patients were divided into group A and group B,with 30 cases in each group.The group A were slowly injected with 0.5 mg/kg of esketamine and 1.5 mg/kg of propofol,while the group B were slowly injected with 0.5μg/kg of remifentanil and 1.5 mg/kg of propofol.The incidences of perioperative respiratory depression,hypotension,nausea and vomiting and body movement in the two groups were recorded;the recovery time,dosage of propofol and Numerical Rating Scale(NRS)score at 10 and 30 min after operation were recorded in the two groups;the patient satisfaction and surgeon satisfaction scores were compared between the two groups.Results The incidences of respiratory depression and hypotension in the group A were significantly lower than those in the group B,and the differences were statistically significant(P<0.05);there were no significant differences in the incidences of nausea and vomiting and body movement between the two groups(P>0.05).There was no significant difference in the recovery time between the two groups(P>0.05);the amount of propofol used in the group A was significantly less than that in the group B,and the NRS score at 10 and 30 min after operation were significantly lower than those in the group B,and the differences were statistically significant(P<0.05).There were no significant differences in the satisfaction scores of patients and surgeons between the two groups(P>0.05).Conclusion Compared with remifentanil combined with propofol,the esketamine combined with propofol in outpatient painless hysteroscopy examination has satisfactory anesthetic effect,with less adverse reactions during operation and less postoperati

关 键 词：艾司氯胺酮 瑞芬太尼 丙泊酚 无痛宫腔镜检查 麻醉效果 不良反应 

分 类 号：R711.75[医药卫生—妇产科学]