舒芬太尼或瑞芬太尼复合丙泊酚麻醉用于宫腔镜电切术的比较

目的比较舒芬太尼或瑞芬太尼复合丙泊酚保留自主呼吸全身麻醉用于宫腔镜电切术的临床效果。方法选择60例美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级择期宫腔镜电切术患者,随机分为A组和B组,每组均为30例。两组先分别静脉注射舒芬太尼0.2μg/kg或泵注瑞芬太尼1μg/kg,均静脉滴注丙泊酚2 mg/kg后开始手术。B组持续泵注瑞芬太尼0.1μg/(kg.mim),患者有体动时追加丙泊酚0.4～1 mg/kg。观察并记录患者给药前、给药后2 min、手术开始后15 min以及手术后5 min时的平均动脉血压、心率、呼吸、脉搏血氧饱和度和起效时间、术后苏醒时间、定向力恢复时间、镇静评分、视觉模拟评分以及不良反应。结果两组患者心率、血压、呼吸、血氧饱和度给药后2 min均有一定程度下降(P<0.05),但组间无统计学意义(P>0.05);术后苏醒时间、定向力恢复时间、镇静评分无统计学意义(P>0.05);A组术后疼痛发生率明显低于B组(P<0.05)。结论舒芬太尼与丙泊酚复合麻醉能更好地用于宫腔镜电切术,更加有效地减轻患者术后疼痛,提高满意率。

Comparison of Sufentanil or Remifentanil Combined with Propofol Anesthesia Used in Hytsteroscopic Electrotomy

Objective To compare the clinical effects of sufentanil or remifentanil combined with propofol in the anesthesia remaining the spontaneous breathing for hysteroscopic electrotomy. Methods Sixty ASA ⅠⅡ cases of elective hysteroscopic electrotomy were ran-domly divided into the group A and B, 30 cases in each group. At first the group A and B were separately given sufentanil 0.2 μg/kg by intravenous injection or remifentanil lug/kg by pumping injection. Then after intravenous drip of propofol 2 mg/kg, the operation was started, remifentanil 0. 1 p~g/kg ＂ rain was continuously pumped in the group B. Propofol 0. g - 1 mg/kg was added when the patient had the body moving. MAP, HR, RR, SPO2, onset time, postoperative revival time, orientation recovery time, calm score, visual analogue scale （VAS） score and adverse reactions before administration, at 2 rain after administration, intraoperative 15 rain and postoperative 5 rain were observed and recorded in the two groups. Results HR, BP, RR, SPO2, at 2 rain after administration in the two groups were de-creased to some extent（P 〈 0. 05）, but without statistical difference between the two groups （P〉 0. 05）. No statistical differences were found in the postoperative revival time, orientation recovery time and calm score （P〉 0.05）.The incidence rate of postoperative pain in the group A was significantly lower than that of the group B （P 〈 0. 05）. Coneluslon Sufentanil and propofol compound anesthesia may be preferably used in hysteroscopic electrotomy, which can effectively relieve postoperative pain and elevate the satisfaction rate.