芬太尼与羟考酮分别复合丙泊酚在宫腔镜手术中的麻醉效果比较

目的]比较芬太尼、羟考酮分别复合丙泊酚在宫腔镜手术麻醉中的效果.方法] 择期行宫腔镜诊疗术的88例患者随机分为两组,各44例,对照组予芬太尼复合丙泊酚麻醉,观察组采用羟考酮复合丙泊酚麻醉,比较两组麻醉不同时间点心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)的变化,比较两组手术情况、术后镇静评分及不良反应发生情况.结果] ①与麻醉前(T0)比较,两组注药完毕(T1)、扩宫(T2)、手术开始5 min(T3)、退扩阴器(T4)时的 HR、MAP、SpO2均降低,且苏醒后(T5)两组MAP均低于T0点(P<0.05),T2、T3、T4点观察组SpO2高于对照组(P<0.05).②两组手术时间、苏醒时间、术后Ramsay镇静评分比较差异无显著性(P>0.05),观察组术中丙泊酚用量低于对照组(P<0.05).③观察组术后不良反应发生率略低于对照组,但差异无显著性(P>0.05).结论] 羟考酮、芬太尼复合丙泊酚用于宫腔镜手术均有较好的镇静效果,但羟考酮复合丙泊酚对患者呼吸抑制作用轻,丙泊酚用量少,且安全性高.

Comparison of Fentanyl and Oxycodone Respectively Combined with Propofol in Hysteroscopic Surgery

Objective]To compared the effects of fentanyl and oxycodone respectively combined with propofol in hysteroscopic surgery.Methods] Eighty-eight patients who underwent elective hysteroscopic surgery were randomly divided into the control group and the observation group with 44 cases in each group.The control group was treated with fentanyl combined with propofol anesthesia, while the observation group was treated with oxycodone combined with propofol.The changes of heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO2), condition of surgery, postoperative sedation scores and incidence of adverse reactions were compared between groups.Results]①HR, MAP and SpO2 at the end of injection (T1), uterine dilation (T2), 5min after the beginning of surgery (T3) and withdrawal of vagina dilator (T4) were lower than those before anesthesia (T0), and after recovery (T5), MAP were lower than those at T0 (P<0.05).At T2, T3 and T4, SpO2 of observation group were higher than those of the control group (P<0.05).②There were no significant differences in the surgical time, recovery time and Ramsay sedation score between the two groups (P>0.05).The dosage of propofol in the observation group was lower than that in the control group during surgery (P<0.05).③The incidence of adverse reactions in the observation group was slightly lower than that in the control group, but the difference was not significant (P>0.05).Conclusion] The sedative effects of both oxycodone and fentanyl combined with propofol are good in hysteroscopic surgery, but oxycodone combined with propofol has little effect on the respiratory inhibition in patients with less dosage of propofol and higher safety.