雷米芬太尼复合丙泊酚在宫腔镜手术中的应用

目的：观察雷米芬太尼复合丙泊酚在宫腔镜手术中的临床效果。方法：选择宫腔镜手术患者60例,随机分为雷米芬太尼复合丙泊酚组（Ⅰ组）和芬太尼复合丙泊酚组（Ⅱ组）。Ⅰ组静注雷米芬太尼1μg/kg,丙泊酚1.5～2.0mg/kg,继而以丙泊酚3mg/（kg·h）加雷米芬太尼0.6μg/（kg·h）输注。Ⅱ组静注芬太尼1μg/kg,丙泊酚2mg/kg,继而以丙泊酚4mg/（kg·h）输注。观察注药前（T0）,注药后5min（T1）、10min（T2）、15min（T3）及停药后5min（T4）的循环、呼吸情况,并记录起效时间、苏醒时间、定向力恢复时间及术中、术后并发症情况。结果：与T0比较,Ⅰ组、Ⅱ组在T1～T3时,HR明显减慢（P〈0.05）,MAP明显下降（P〈0.05）;T4时Ⅰ组的MAP、HR与T0比较差异无统计学意义,而Ⅱ组的MAP明显降低（P〈0.05）,HR明显减慢（P〈0.05）;Ⅰ组术中体动小于Ⅱ组（P〈0.01）,起效时间、苏醒时间、定向力恢复时间快于Ⅱ组（P〈0.05）。结论：雷米芬太尼复合丙泊酚用于宫腔镜手术,起效快、苏醒迅速、不良反应小、安全、可行。

The using of remifentanil and propofol in hysteroscopic surgery

Objective：Observated the clinical effect of composite remifentanil and propofol at hysteroscopy.Methods：60 cases of hysteroscopic surgery in patients were randomly divided into group of composite remifentanil and propofol（Ⅰgroup） and group of composite propofol and fentanyl（Ⅱ group）.Intravenous remifentanil 1 μg/kg and propofol 1.5～2.0 mg/kg in groupⅠ,then propofol infusion by 3 mg/（kg·h） and remifentanil infusion by 0.6 μg/（kg·h）.Intravenous fentanyl 1 μg/kg and propofol 2 mg/kg in group Ⅱ,then propofol infusion by 4 mg/（kg·h）.Observed the circulatory,respiratory conditions before injection（T0）,after injection 5 min（T1）,10 min（T2）,15 min（T3） and after stopping 5 min（T4）.And recorded the effect time,recovery time,orientation recovery time and complications in intraoperative and postoperative.Results：Compared with T0,Ⅰ and Ⅱ group at T1～T3,HR significantly slower（P〈0.05）,MAP decreased significantly（P〈0.05）.MAP,HR of the group Ⅰ on T4compared with T0 had no significant difference,but MAP decreased significantly（P〈0.05）,HR significantly slower（P〈0.05）in the group Ⅱ.Group Ⅰ body moving in operative less than in group Ⅱ.Onset time,recovery time,recovery time quick orientation in group Ⅱ（P〈0.05）.Conclusion：Remifentanil propofol compound for quick effect hysteroscopic surgery,regained consciousness quickly and adverse reactions of small,safe and feasible.