靶控输注瑞马唑仑和丙泊酚对妇科宫腔镜手术患者麻醉效果的对比研究  

Comparative study on the effect of the target-controlled infusion of remimazolam and propofol on the anesthetic effect of patients during gynecological hysteroscopy surgery

作　　者：杨广标 梁小龙 吴靦 林吉力 代文化 金俊 YANG Guangbiao;LIANG Xiaolong;WU Mian;LIN Jili;DAI Wenhua;JIN Jun(Zhongshan Sixth People's Hospital,Zhongshan,Guangdong Province,528437;Yangjiang People's Hospital,Yangjiang,Guangdong Province)

机构地区：[1]广东省中山市第六人民医院,528437 [2]广东省阳江市人民医院

出　　处：《中国计划生育学杂志》2024年第12期2805-2810,共6页Chinese Journal of Family Planning

基　　金：中山市卫生局项目(2022A020617)。

摘　　要：目的:对比观察靶控输注(TCI)瑞马唑仑和丙泊酚对妇科宫腔镜手术患者苏醒时间、心率(HR)、平均动脉压(MAP)的影响。方法:选取2022年8月-2023年10月本院行宫腔镜手术治疗的患者80例,按随机数字法分为对照组和观察组各40例,术中分别给予TCI丙泊酚或TCI瑞马唑仑。记录两组麻醉起效时间、苏醒时间、苏醒质量(10 min、20min、30min的Aldrete评分)、在麻醉前(T0)、麻醉后3min(T1)、扩宫(T2)与及清醒后(T3)时的HR、MAP、呼吸频率(RR)、氧饱和度(SpO_(2))和脑电双频指数(BIS)、术中感觉运动阻滞、术后2h的镇静(Ramsay镇静评分)及镇痛[视觉模拟量表(VAS)]效果、麻醉相关不良反应。结果:观察组麻醉起效时间(2.27±0.57min)、苏醒时间(5.17±1.77min)、镇静(0.98±0.39分)及镇痛(3.01±0.29分)评分均少于对照组(2.56±0.68、5.96±1.68、1.24±0.59分、3.26±0.15分)(均P<0.05),Aldrete评分(7.80±0.41分、8.80±0.41分、9.00±0.64分)高于对照组(6.60±0.50分、7.60±0.50分、8.40±0.50分),T1~T3时的HR、MAP、RR及SpO_(2)变化程度小于对照组(均P<0.05),两组BIS、运动阻滞及麻醉相关不良反应无差异(P>0.05)。结论:TCI瑞马唑仑和TCI丙泊酚均可用于妇科宫腔镜手术,与TCI丙泊酚比,TCI瑞马唑仑在改善患者术后苏醒、维护围术期HR、MAP、RR及SpO_(2)、提高麻醉效率方面有明显优势。Objective:To compare the effects of the target-controlled infusion(TCI)of remimazolam and propofol for patients during gynecological hysteroscopy surgery on their awakening time,heart rate(HR)and mean arterial pressure(MAP).Methods:80 patients who wanted hysteroscopic surgery in the hospital were selected and were randomly divided into control group and observation group(40 cases in each group)from August 2022 to October 2023.The patients in the control group were given TCI propofol for anesthesia during surgery,while the patients in the observation group were given TCI remimazolam for anesthesia during surgery.The onset time of anesthesia,the awakening time,the awakening quality evaluated by Aldrete score at 10,20,and 30 minutes after surgery,the values of HR,MAP,respiratory rate(RR)and oxygen saturation(SpO_(2)),the bispectral index(BIS)at before anesthesia(TO),3 minutes after anesthesia(T1),dilation(T2)and awakening(T3),the intraoperative sensory motor block,the Ramsay sedation score,the analgesia effect evaluated by visual analog scale(VAS)at postoperative 2 hours,and the anesthesia related adverse reactions rate of the patients were recorded and were compared between the two groups.Results:The onset time of anesthesia(2.27±0.57 min),the awakening time(5.17±1.77 min),the scores of sedation(0.98±0.39 points)and analgesia(3.01±0.29 points)of the patients in the observation group were significantly less than those(2.56±0.68 min,5.96±1.68 min,1.24±0.59 points and 3.26±0.15 points)of the patients in the control group(all P<0.05).The Aldrete scores of the patients in the observation group at T0-T3(7.80±0.41 points,8.80±0.41 points and 9.00±0.64 points)were significantly higher than those(6.60±0.50 points,7.60±0.50 points and 8.40±0.50 points)of the patients in the control group.The changes of the values of HR,MAP,RR and SpO_(2)of the patients in the observation group at T1-T3 were significantly less than those of the patients in the control group(all P<0.05).There were no significant differences in th

关 键 词：宫腔镜手术 瑞马唑仑 丙泊酚 靶控输注 麻醉效果 镇痛镇静 不良反应 

分 类 号：R614[医药卫生—麻醉学]