宫腔镜手术采用不同静脉全麻的效果比较

目的探讨宫腔镜手术中采用咪达唑仑复合芬太尼及丙泊酚不插管静脉全身麻醉与顺苯磺酸阿曲库铵复合咪达唑仑、芬太尼及丙泊酚气管内插管静脉全身麻醉的临床麻醉效果与安全性。方法选择妇科宫腔镜手术患者200例,按随机数字表法分为试验组和对照组各100例。试验组采用顺苯磺酸阿曲库铵复合咪达唑仑、芬太尼及丙泊酚气管内插管静脉全身麻醉,对照组采用咪达唑仑复合芬太尼及丙泊酚静脉全身麻醉。监测记录两组患者心率(HR)、平均血压(MAP)、血氧饱和度(SpO2)、术中体动、术者对麻醉满意度、手术时间、睁眼时间,术后24小时回访有无术中知晓及麻醉并发症。结果对照组术中SpO2<95%发生38例,术中体动发生8例,术者稍有不满意28例;试验组术中SpO2均维持在98%～100%,术中无体动,术者满意度100%。两组患者HR、MAP都有不同程度下降,手术时间、芬太尼及丙泊酚用量、术毕呼吸、睁眼时间、术后并发症比较差异均无统计学意义(P>0.05)。结论在宫腔镜手术中应用顺苯磺酸阿曲库铵复合咪达唑仑、芬太尼及丙泊酚气管内插管静脉全身麻醉能提供良好手术环境,便于术中呼吸管理,术后患者呼吸、意识恢复快速,是安全有效的。

Intravenous anesthesia with tracheal intubation in hysterocscopic electrocision

Objective To evaluate the effects and safety of intravenous general anesthesia with tracheal intubation in hysterocseopie electrocision surgery. Methods 20050 patients undergoing hysteroescopic electroeision surgery were randomly divided into the group （Group A, n = 100）were treated by midazolam, propofol and fentanyl without tracheal intubation and the control group （Group A, n = 100）were received midazolam, propofol fentanyl and eisatracurium besilate with tracheal intubation. The HR, MAP and SpO2 were recorded. The movement, the surgeon satisfaction, the fentanyl and propofol dosage, the operation time, the analgesia time and anesthetic complication were evaluated. Results Compared with group A, there was no body movement in group B and the SpO2 remained at 98%- 100%. The HR and MAP in both two groups decreased during the surgery. There is no significant difference in the fentanyl and propofol dosage, the operation time, the analgesia time and anesthetic complication between group A and group B. Conclusion Intravenous general anesthesia with tracheal intubation in hysterocscopie eleetrocision surgery may provide better anesthesia effects and is safe.