地佐辛复合异丙酚用于无痛宫腔镜的临床观察

目的观察地佐辛复合异丙酚用于无痛宫腔镜的麻醉效果。方法选择自愿要求宫腔镜手术患者45例,随机均分为3组：Ⅰ组予异丙酚＋地佐辛治疗,Ⅱ组予异丙酚＋芬太尼治疗,Ⅲ组单纯予异丙酚。观察3组患者入室后给药前（T0）、睫毛反射消失时（T1）、扩宫颈时（T2）、宫腔操作时（T3）、术毕时（T4）以及唤醒时（T5）的MAP、HR、RR及Sp（O2）,记录异丙酚总用量、唤醒时间、手术时间以及苏醒时的宫缩痛视觉模拟评分（VAS）,记录手术医生对麻醉效果评价,观察不良反应。结果 T1时点各组MAP及HR均显著低于T0时点（P均〈0.05）。Ⅱ组的RR在T1时点明显低于Ⅰ组和Ⅲ组（P均〈0.05）。Ⅲ组异丙酚总用量显著大于Ⅰ组及Ⅱ组（P均〈0.05）,Ⅲ组唤醒时间明显长于Ⅰ组及Ⅱ组（P均〈0.05）。术中麻醉效果优良率Ⅲ组明显优于Ⅰ级及Ⅱ组（P均〈0.05）,而术后宫缩痛VAS评分Ⅰ组及Ⅱ组明显低于Ⅲ组（P均〈0.05）。恶心呕吐的发生率Ⅱ组明显高于Ⅰ组及Ⅲ组（P均〈0.05）;头昏及兴奋躁动发生率Ⅰ组及Ⅱ组明显低于Ⅲ组（P均〈0.05）。结论地佐辛复合异丙酚用于宫腔镜手术具有血流动力学平稳、镇痛效果确切、苏醒迅速、麻醉期间不良反应及麻醉后并发症少等优点。

Clinical observation of dezocine combined with propofol for painless hysteroscope surgery

Objective It is to observe the anesthesia effect of dezocine combined with propofol for painless hysteroscope surgery. Methods Forty-five patients who voluntary requested for hysteroscopes surgery were randomly divided into three groups： Group I was treated by propofol combined with dezocine, Group II was treated by propofol combined with fentanyl, and Group III was treated by propofol alone. MAP, HR, RR and Sp（ 02 ） were observed of each group at five time point： before anesthesia （ T0 ） , when loss of eyelash reflex （ T2 ） , during operation （ T3 ） , after operation （ T4 ） , when awaking from anesthesia （T5 ）. The total amounts of propofol, time of wake-up, operation time of surgery, VAS score of pain after consciousness, and the evaluation from surgeon for anesthesia effect were recorded. The adverse reaction during anesthesia and complications after anesthesia were observed. Results MAP, HR at T1 time point was significantly lower than that at TO time point （P 〈 0.05）. RR of Group I1 at T1 point was significantly lower than that of group I and III （P 〈 0.05）. The total amount of propofol group III was significantly higher than group I and II （P 〈 0.05） , and wake-up time of group m was longer than group I and II （P 〈0.05）. The number for excellent evaluation of group III was less than group I and II during intraoperative anesthesia and the number for bad evaluation of group III was more than group I and II. The difference between groups was statistically significant （P 〈 0.05）. VAS score of pain after surgery of group I and II was obviously lower than that of group III （ P 〈 0.05 ）. The incidence of vomiting after operation was obviously high in group II than that in group I and III （ P 〈 0.05 ）. The incidence of dizziness excitation and restless in group I and II was obviously lower than that in group III （ P 〈 0.05 ）. Conclusion Dezocine combined with propofol for painless hysteroscope surgery has the advantage of stable hemodynamics, exact analgesic effect, waking up quickly, and reduced adverse complication during and after anesthesia.