艾司氯胺酮与羟考酮在宫腔镜手术中麻醉效果与苏醒质量的比较分析  

Comparative analysis of anesthetic efficacy and recovery quality between esketamine and oxycodone in hysteroscopic surgery

作　　者：秦娅 焦皓 Qin Ya;Jiao Hao(Department of Anesthesiology,Xuzhou Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;School of Anesthesiology,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China)

机构地区：[1]徐州医科大学附属徐州市妇幼保健院麻醉科,江苏徐州221000 [2]徐州医科大学麻醉学院,江苏徐州221004

出　　处：《齐齐哈尔医学院学报》2025年第5期439-443,共5页Journal of Qiqihar Medical University

基　　金：江苏省自然科学基金(BK20161155)。

摘　　要：目的比较艾司氯胺酮与羟考酮在宫腔镜手术中的麻醉效果与苏醒质量。方法选择2023年4-12月本院收治的80例拟择期行宫腔镜手术的患者作为研究对象,采用随机数表法分为艾司氯胺酮组(S组)与羟考酮组(O组)两组,每组各40例。S组给予艾司氯胺酮0.2 mg/kg和丙泊酚2.0 mg/kg进行麻醉诱导,O组给予羟考酮0.1 mg/kg和丙泊酚2.0 mg/kg进行麻醉诱导。两组患者均采用改良警觉/镇静评分(MOAA/S)进行镇静深度评估,评分低于2分开始手术。术中发生体动反应则追加丙泊酚0.5~1.0 mg/kg。手术结束将患者送入麻醉恢复室(PACU)继续观察。记录两组患者入手术室时(T_(0))、睫毛反射消失时(T_(1))、扩宫时(T_(2))、手术结束时(T_(3))、意识清醒时(T_(4))的心率(HR)、平均动脉压(MAP)、脉氧饱和度(SpO_(2));记录诱导期呛咳、术中体动、呼吸抑制、心动过缓、低血压以及术后恶心呕吐发生情况;记录手术时间、苏醒时间、PACU治疗时间以及术中丙泊酚总用量;采用视觉模拟评分法(VAS)评价苏醒后5 min以及苏醒后30 min宫缩痛情况。结果T_(0)、T_(3)和T_(4)时间点,两组患者的心率HR、平均动脉压MAP、血氧饱和度SpO_(2)比较,差异均无统计学意义(P>0.05);T_(1)和T_(2)时间点,S组患者的心率HR、平均动脉压MAP、血氧饱和度SpO_(2)高于O组,差异均具有统计学意义(P<0.05);两组患者诱导期呛咳发生率相比,差异无统计学意义(P>0.05);S组患者术中体动、呼吸抑制、心动过缓、低血压及术后恶心呕吐发生率低于O组,差异均有统计学意义(P<0.05);两组患者的手术时间和术后宫缩痛(VAS评分)比较,差异无统计学意义(P>0.05);S组患者的术中丙泊酚总用量、苏醒时间和恢复室治疗时间低于O组,差异有统计学意义(P<0.05)。结论艾司氯胺酮复合丙泊酚应用于宫腔镜手术,麻醉效果好且苏醒质量高,对呼吸和循环影响小,安全有效。Objective To compare the anesthetic effects and recovery quality of esketamine and oxycodone in hysteroscopic surgery.Methods A total of 80 patients scheduled for hysteroscopic surgery from April 2023 to December 2023 were randomly assigned into two groups:the esketamine group(Group S)and the oxycodone group(Group O),with 40 patients in each group.Group S received esketamine 0.2 mg/kg and propofol 2.0 mg/kg for anesthesia induction,while Group O received oxycodone 0.1 mg/kg and propofol 2.0 mg/kg for anesthesia induction.Both groups were assessed for sedation depth using the Modified Observer's Assessment of Alertness/Sedation(MOAA/S)scale,and surgery commenced when the score is below 2.Additional propofol 0.5~1.0 mg/kg was administered intraoperatively in response to body movement.After the surgery,the patients were transported to the post-anesthesia care unit(PACU)for continued observation.Heart rate(HR),mean arterial pressure(MAP),and pulse oxygen saturation(SpO_(2))were recorded at the Patient's entry time into the operating room(T_(0)),time of disappearance of eyelash reflex(T_(1)),time of cervical dilation(T_(2)),time of surgery completion(T_(3)),and time of patients'regain of consciousness(T_(4)).Incidences of cough during induction,intraoperative body movement,respiratory depression,bradycardia,hypotension,and postoperative nausea and vomiting(PONV)were documented.Surgical duration,recovery time,treatment time in the PACU,and total intraoperative propofol dosage were also recorded.Visual Analog Scale(VAS)scores were used to evaluate uterine contraction pain at 5 minutes and 30 minutes after recovery.Results Compared with Group O,Group S exhibited significantly higher HR,MAP,and SpO_(2)at T_(1)and T_(2)time points(P<0.05).The incidence of intraoperative body movement,respiratory depression,bradycardia,hypotension,and PONV was lower in Group S than in Group O(P<0.05).The total propofol dosage during surgery,recovery time,and treatment time in the recovery room were also lower in Group S compared to Group O(

关 键 词：艾司氯胺酮 羟考酮 宫腔镜 苏醒质量 

分 类 号：R614[医药卫生—麻醉学]