右旋美托咪定复合异丙酚在宫腔镜手术中的临床观察

目的:比较右旋美托咪定复合异丙酚与瑞芬太尼复合异丙酚及异丙酚单独应用在宫腔镜手术中的效果及安全性。方法:选择拟施行宫腔镜手术患者75例,随机分组A、B、C三组,每组25例。A组用右旋美托咪定复合异丙酚麻醉,B组用瑞芬太尼复合异丙酚麻醉,C组单用异丙酚麻醉。记录三组术中平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、异丙酚累计用量、意识消失时间、手术时间﹑意识恢复时间、术后宫缩痛评分和恶心呕吐﹑注射痛等并发症、操作者及患者的满意度。结果:三组血流动力学差异无统计学意义(P>0.05)。A组和B组较C组患者异丙酚用量减少,意识恢复时间缩短,差异有统计学意义(P<0.05)。A组较B组和C组术后宫缩痛VAS评分较低,呼吸抑制发生率低,满意度高,差异有统计学意义(P<0.05)。结论:右旋美托咪定复合异丙酚行宫腔镜手术是安全有效的,且能降低术后疼痛,是宫腔镜手术好的选择。

Clinical observation on dexmedetomidine combined with compound propofol used for hysteroscopic surgery

Objective:To compare the efficacies and safeties of dexmedetomidine combined with compound propofol,remifentanil combined with compound propofol,and propofol alone used for hysteroscopic surgery. Methods:Seventy-five patients receiving hysteroscopic surgery were selected and randomly divided into group A,group B,and group C,25 patients in each group.The patients in group A were treated with dexmedetomidine combined with compound propofol,the patients in group B were treated with remifentanil combined with compound propofol,and the patients in group C were treated with propofol.The mean arterial pressures(MAP),heart rates(HR),oxyhemoglobin saturations,accumulated doses of propofol,disappearance times of consciousness,operation times,recovery times of consciousness,scores of postoperative uterine contraction pain,complications(such as nausea and vomiting,injection pain),satisfaction degrees of patients and operators in the three groups were recorded. Results:There was no statistically significant difference in hemodynamics among the three groups(P>0.05).Compared with group C,the doses of propofol in group A and group B decreased,the recovery times of consciousness shortened,there were statistically significant differences(P<0.05).Compared with group B and group C,VAS score of postoperative uterine contraction pain in group A was lower,the morbidity of respiratory depression decreased,the satisfaction degree increased,there were statistically significant differences(P<0.05). Conclusion:Dexmedetomidine combined with compound propofol used for hysteroscopic surgery is safe and effective,which can reduce postoperative pain,and the method is a good choice for hysteroscopic surgery.