宫腔镜手术中应用右美托咪定复合异丙酚的麻醉效果

】目的研究和观察右美托咪定复合异丙酚及异丙酚静脉麻醉在妇产科宫腔镜手术中的应用效果。方法择期宫腔镜手术患者80例，随机均分为异丙酚组（P组）和异丙酚加右美托咪定组（PY组），各40例。观察并记录手术前（T0）、诱导后（T1）、扩宫时（T2）、清除肿物（或异物）时（B）、手术结束时（T4）的MAP、HR、SpO2，记录异丙酚的诱导时间、手术时间、清醒时间、有无肢体运动、有无呼吸暂停及苏醒后患者对镇静镇痛的评价及有无术后宫缩痛。结果PY组异丙酚诱导时间明显短于P组（P〈0．05），P组在T1、T2点MAP低于PY组（P〈0．05）；不良反应观察结果显示：术中PY组患者肢体活动明显低于P组，分别为6例和16例（P〈0．05）；呼吸暂停P组12例，多于PY组4例（P〈0．05）；P组患者对镇静镇痛不满意例数8例，高于PY组1例（P〈0．05），P组有术后宫缩痛12例，多于PY组4例（P〈0．05）。结论右美托咪定复合异丙酚静脉麻醉既能保证手术安全顺利地实施又能增加患者的满意度，减少术后宫缩痛．是宫腔镜手术较为理想的麻醉方式。

Effect of dexmedetomidine combined with propofol applied in hysteroscopy

Objective To investigate the effect of dexmedetomidine combined with propofol applied in hysteroscopy.Methods Eighty patients scheduled for selective hysteroscopy were assigned to two groups: group P(propofol) and group PY(dexmedetomidine combined with propofol).Each group had forty cases.MAP,HR,SpO2 were recorded at 5 time points:before surgery(T0),after induction(T1),cervical enlarged(T2),uterine content removal(T3) and end of surgery(T4).Induction time,recovery time,stess respond.Respiration depression were recorded during the surgery.Evaluation of sedation and pain of uterine contraction were recorded.Results Induction time of propofol in group PY was shorter than that in group Y.MAP in group P at T1,T2 was lower than that in group PY.Stess respond in group PY was significantly decreased as compared with that in group P(P < 0.05).Respiratory depression in group P was 12 cases,more than 4 cases in goup P Y(P < 0.05).Patients dissatisfaction in group P was 8 cases,more than 1 case in group P(P < 0.05).Pain of uterine contraction in group P was 12 cases,more than 4 cases in group P.Conclusion Dexmedetomidine combined with propofol appiled in hysteroscopy can not only ensure the safety of surgery,but also reduce pain of uterine contraction,increase patient satisfaction,is an ideal anesthesia method in hysteroscopy.