纳布啡和地佐辛分别复合丙泊酚用于宫腔镜手术的临床观察

目的比较纳布啡和地佐辛分别复合丙泊酚用于宫腔镜手术的效果和安全性。方法选取2019年2月至2020年2月在静脉全身麻醉下行宫腔镜手术的患者240例,随机分为纳布啡组(A组)、地佐辛组(B组)与丙泊酚组(C组),每组80例。A组麻醉方案为0.15 mg/kg纳布啡+2 mg/kg丙泊酚;B组麻醉方案为0.1 mg/kg地佐辛+2 mg/kg丙泊酚;C组麻醉方案为2 mg/kg丙泊酚。比较3组患者入室时(T0)、丙泊酚推注完毕即刻(T1)、扩张宫口时(T2)、手术结束时(T3)、麻醉苏醒时(T4)的SBP、DBP、HR、SpO2等指标,并比较3组患者丙泊酚总用量、手术时间、苏醒时间(自手术结束至完全清醒并能正确应答)、苏醒后5 min VAS评分、不良反应发生率。结果与T0相比,3组患者在T1、T2、T3、T4时SBP、DBP、HR、SpO2值均明显下降(P<0.05)。与C组比较,A组和B组患者体动反应较少、丙泊酚总用量较少、苏醒时间缩短、苏醒后5 min的VAS评分较低(P<0.05)。B组患者不良反应总发生率明显高于A组,C组患者不良发应总发生率明显高于A组和B组,差异均有统计学意义(P<0.05)。结论0.15 mg/kg纳布啡+2 mg/kg丙泊酚的药物配比用于宫腔镜手术安全性较高,不良反应较少,值得临床推广应用。

Clinical observation of the efficacy and security of propofol combined with naborphine and dizosin in hysteroscopic surgery

Objective To compare the efficacy and security of propofol combined with naborphine and dizosin in hysteroscopic surgery.Methods 240 patients undergoing hysteroscopic surgery suffering intravenous general anesthesia from February 2019 to February 2020 were randomly divided into nabufine group(group A),dizosin group(group B),propofol group(group C),with 80 cases in each group.In group A,0.15 mg/kg naborphine+2 mg/kg propofol;in group B,0.1 mg/kg dizosin+2 mg/kg propofol;in group C,2 mg/kg propofol.The observation indexes including SBP,DBP,HR and SpO2,were respectively compared at the time of admission(T0),immediately after propofol injection(T1),at the time of cervical dilatation(T2),at the end of operation(T3),and at the time of anesthesia recovery(T4)were compared among three groups.Compared the total dosage of propofol,operation time,wake-up time(from operation ending to patients were thoroughly awake and able to respond correctly),VAS score in 5 minutes after wake-up,adverse reactions among three groups.Results Compared with T0,SBP,DBP,HR and SpO2 of three groups were significantly decreased at T1,T2,T3 and T4(P<0.05).Compared with group C,patients in group A and B had less body movement reaction,less total propofol dosage,shorter wake-up time and lower VAS score in 5 minutes after wake up(P<0.05).The total incidence of adverse reactions in group B was significantly higher than that in group A;the total incidence of adverse reactions in group C was significantly higher than that in group A and group B,the difference was statistically significant(P<0.05).Conclusion The drug ratio of 0.15 mg/kg naborphine+2 mg/kg propofol in hysteroscopic surgery has higher safety and less adverse reactions,which is worthy of clinical application.