宫腔镜检查术中应用两种不同剂量环泊酚复合芬太尼的麻醉效果比较  

Comparison of the anesthetic effect of the different doses of ciprofol combined with fentanyl used in hysteroscopic examination

作　　者：吕慧敏[1] 张化[1] 年春苗[1] LV Huimin;ZHANG Hua;NIAN Chunmiao(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province,450052)

机构地区：[1]郑州大学第一附属医院,450052

出　　处：《中国计划生育学杂志》2024年第12期2821-2826,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨两种不同剂量环泊酚复合芬太尼对宫腔镜检查术患者的麻醉效果。方法:选取2022年6月-2024年3月本院拟行宫腔镜检查术患者256例,随机数字表法分为低剂量组(0.4mg/kg环泊酚+1μg/kg芬太尼)和高剂量组(0.6mg/kg环泊酚+1μg/kg芬太尼)各128例。比较两组Ramsay镇静评分、麻醉诱导时间、苏醒时间、环泊酚用量、不同时刻生命体征、术后视觉模拟疼痛评分(VAS)及不良反应情况。结果:低剂量组Ramsay镇静评分(1.19±0.65分)、苏醒时间(6.83±2.56min)、环泊酚用量(27.62±4.29mg)均低于高剂量组(2.76±0.74分、8.04±2.76min、32.87±4.81mg),麻醉诱导时间(57.39±20.37s)高于高剂量组(51.58±18.48s)(P<0.05)。麻醉前(T0)、麻醉3min后(T1)、手术结束时(T3)平均脉动压(MAP)、心率(HR)两组比较均无差异(P>0.05),扩宫时(T2)低剂量组的MAP、HR高于高剂量组(P<0.05);两组T0、T3时呼吸频率(RR)、血氧饱和度(SpO_(2))无差异(P>0.05),T1、T2时低剂量组RR、SpO_(2)均高于高剂量组(均P<0.05)。低剂量组术后10min、30minVAS评分(2.04±0.64分、1.29±0.38分)均高于高剂量组(1.82±0.59分、1.16±0.32分),呼吸抑制发生率(4.7%)低于高剂量组(11.7%),术中体动发生率(18.8%)高于高剂量组(6.3%)(均P<0.05)。结论:0.4mg/kg和0.6mg/kg两种不同剂量环泊酚复合芬太尼均可满足宫腔镜检查术的麻醉需求,0.4mg/kg环泊酚对呼吸循环系统的抑制作用较小,具有更短的苏醒时间;而0.6 mg/kg环泊酚镇静、镇痛效果更佳,可减少术中体动发生。Objective:To explore the anesthetic effect of the different doses of ciprofol combined with fentanyl used in hysteroscopic examination of patients.Methods:256 patients who scheduled to undergo hysteroscopic examination in the hospital were selected and were divided into two groups(128 cases in each group)according to the random number table method from June 2022 to March 2024.The patients in group A were given 0.4 mg/kg ciprofol+1μg/kg fentanyl for anesthesia and the patients in group B were given 0.6 mg/kg ciprofol+1μg/kg fentanyl for anesthesia.The Ramsay sedation score,the anesthesia induction time,the awakening time,the dosage of ciprofol used,the vital signs values at different time points,the postoperative visual analogue pain score(VAS)and the adverse reaction rate of the patients were compared between the two groups.Results:The Ramsay sedation score(1.19±o.65 points),the awakening time(6.83±2.56min)and the dosage of cyclopropofol used(27.62±4.29mg)of the patients in group A were significantly lower than those(2.76±0.74 points,8.04±2.76min and 32.87±4.81mg)of the patients in group B.The time of anesthesia induction(57.39±20.37s)of the patients in group A was significantly higher than that(51.58±18.48s)of the patients in group B(P<0.05).There were no significant differences in the values of the mean pulse pressure(MAP)and the heart rate(HR)of the patients before anesthesia(T0),3min after anesthesia(T1)and at the end of operation(T3)between the two groups(P>0.05).The values of MAP and HR of the patients in group A at the time of uterine expansion(T2)were significantly higher than those of the patients in group B(P<0.05).There was no significant difference in the values of respiratory rate(RR)and blood oxygen saturation(SpO_(2))of the patients at T0 and T3 between the two groups(P>0.05).At T1 and at T2,the values of RR and SpO_(2)of the patients in group A were significantly higher than those of the patients in group B(all P<0.05).The VAS scores of the patients in group A at 10min and ate 30min afte

关 键 词：宫腔镜检查 环泊酚 芬太尼 镇痛 生命体征 

分 类 号：R614[医药卫生—麻醉学]