氟马西尼静脉注射对鼻咽通气全凭静脉麻醉宫腔镜手术患者苏醒期质量的影响  

Effect of Intravenous Flumazenil on the Quality of Recovery in Patients Undergoing Hysteroscopic Surgery under Total Intravenous Anesthesia with Nasopharyngeal Ventilation

作　　者：刘凯 吴黎生 王震 LIU Kai;WU Li-sheng;WANG Zhen(Department of Anesthesiology,Zhumadian Central Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市中心医院麻醉科,驻马店463000

出　　处：《中国合理用药探索》2024年第11期103-107,共5页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨氟马西尼静脉注射对鼻咽通气全凭静脉麻醉宫腔镜手术患者苏醒期质量的影响。方法:选取2021年7月~2024年2月期间于某院行宫腔镜手术的92例患者作为研究对象,采用随机数字表法分为对照组和观察组,每组46例。对照组患者给予全凭静脉麻醉(注射用苯磺酸瑞马唑仑联合盐酸羟考酮注射液),观察组患者术毕在对照组麻醉基础上给予氟马西尼注射液。比较两组患者苏醒时间、定向力恢复时间、镇静效果(Ramsay评分)、应激反应[去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)水平]、疼痛情况[视觉模拟评分(VAS)]及不良反应发生情况。结果:观察组患者苏醒时间、定向力恢复时间均短于对照组(P<0.05);镇静效果优于对照组(P<0.05);两组患者术后24h NE、E和Cor水平比较均无统计学差异(P>0.05);2、6、12h和24hVAS评分比较均无统计学差异(P>0.05);嗜睡、恶心呕吐、头晕、心动过缓等不良反应总发生率比较无统计学差异(P>0.05)。结论:氟马西尼静脉注射可促进鼻咽通气全凭静脉麻醉宫腔镜手术患者麻醉苏醒和恢复,未影响应激反应水平和术后疼痛水平,且未增加不良反应的发生风险。Objective:To investigate the effect of intravenous flumazenil on the quality of recovery in patients undergoing hysteroscopic surgery under total intravenous anesthesia with nasopharyngeal ventilation.Methods:A total of 92 patients who underwent hysteroscopic surgery in a hospital from July 2021 to February 2024 were selected and assigned to the control group and observation group by random number table method,with 46 patients in each group.The control group was given total intravenous anesthesia(remimazolam besylate for injection combined with oxycodone hydrochloride injection),while the observation group was additionally given flumazenil injection at the end of surgery.The recovery time,orientation recovery time,sedation effect(Ramsay score),stress response[norepinephrine(NE),epinephrine(E),cortisol(Cor)levels],pain condition[visual analogue scale(VAS)]and adverse reactions were compared between the two groups.Results:The recovery time and orientation recovery time of the observation group was shorter than that of the control group(P<0.05).The sedation effect of observation group was better than that of control group(P<0.05).There was no statistically significant difference in NE,E and Cor levels between the two groups at 24h following surgery(P>0.05).There was no statistically significant difference in VAS scores between the two groups at 2h,6h,12h and 24h after surgery(P>0.05).There was no statistically significant difference in the total incidence of adverse reactions such as somnolence,nausea and vomiting,dizziness and bradycardia between the two groups(P>0.05).Conclusions:Intravenous flumazenil can promote anesthesia awakening and recovery in patients who underwent hysteroscopic surgery under total intravenous anesthesia with nasopharyngeal ventilation,without affecting stress response levels and postoperative pain levels,and without increasing the risk of adverse reactions.

关 键 词：氟马西尼 全凭静脉麻醉 宫腔镜手术 苏醒时间 应激反应 不良反应 

分 类 号：R614[医药卫生—麻醉学]