宫颈旁阻滞联合表面麻醉在浅全麻宫腔镜检查中的有效性及安全性分析

目的探讨宫颈旁阻滞联合表面麻醉在浅全麻宫腔镜检查中的有效性及安全性。方法选择沧州中西医结合医院2017年1月至2018年1月收治的宫腔镜检查患者200例,按照完全随机数字表将患者分为观察组和对照组,各100例。观察组给予宫颈旁阻滞联合表面麻醉,对照组仅给予丙泊酚静脉全麻。观察两组麻醉安全性和有效性。结果两组患者宫颈松弛度均较好,差异无统计学意义(P>0.05)。与对照组比较,观察组术中丙泊酚用量减少(132.47±23.28) mgvs (167.72±30.81) mg],苏醒时间缩短(9.47±1.48) min vs (11.72±1.62) min],术后6 h时疼痛视觉模拟评分降低(1.54±0.38)分vs (1.67±0.41)分],恶心呕吐发生率降低(1.00%vs8.00%),差异均有统计学意义(P<0.05)。两组患者其他不良反应比较,差异无统计学意义(P>0.05)。两组患者不同时间点平均动脉压,麻醉前5 min(T0)心率比较,差异均无统计学意义(P>0.05)。与对照组比较,扩宫时(T1)、手术开始后5 min(T2)、退扩阴器(T3)、苏醒时(T4)观察组心率均低于对照组,差异有统计学意义(P<0.05)。结论宫颈旁阻滞联合表面麻醉在宫腔镜检查中,具有较好的安全性,对患者血流动力学影响较小,有效减少全麻药物用量和不良反应。

Efficacy and safety of paracervical block combined with surface anesthesia in hysteroscopy under general anesthesia

Objective To investigate the efficacy and safety of paracervical block combined with surface anesthesia in hysteroscopy under general anesthesia.Methods A total of 200 hysteroscopy patients admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2017 to January 2018 were selected.According to the principle of complete random number table, the patients were randomly divided into an observation group and a control group, each with 100 cases.The observation group was given para cervical block combined with surface anesthesia, and the control group was given propofol intravenous anesthesia.The anesthesia safety and efficacy of the two groups were observed.Results Cervical relaxation was good in the two groups, and the difference was not statistically significant(P>0.05).Compared with the control group, the amount of propofol in the observation group was significantly reduced (132.47±23.28) mg vs(167.72±30.81) mg], and the wake-up time was shortened (9.47±1.48) min vs(11.72±1.62) min ] at 6 hours after surgery, the visual analogue score of pain decreased (1.54±0.38) points vs(1.67±0.41) points], and the incidence of nausea and vomiting decreased(1.00 % vs 8.00 %), and the differences were statistically significant(P<0.05).There were no significant differences in other adverse reactions between the two groups(P>0.05).There was no significant difference in the mean arterial pressure at different time points and the heart rate 5 minutes before anesthesia(T0) between the two groups of patients(P>0.05).Compared with the control group, the heart rate of the observation group was lower than that of the control group at the time of dilation(T1), 5 minutes after the start of surgery(T2), withdrawal of the genitals(T3), and at the time of awake(T4), and the differences were statistically significant(P<0.05).Conclusion Para cervical block combined with surface anesthesia in hysteroscopy is safer, has less influence on hemodynamics, and can effectively reduce the general anesthetic dosage and adverse reactions.