羟考酮复合丙泊酚用于宫腔镜手术麻醉安全性和效果研究-现代医学

羟考酮复合丙泊酚用于宫腔镜手术麻醉安全性和效果研究

作者：张钧章利

单位：南京医科大学附属淮安市第一人民医院

分类号：

出版年·卷·期（页码）：2015·43·第十二期（1533-1535）

摘要：

[摘要]目的：观察羟考酮复合丙泊酚静脉麻醉应用于宫腔镜手术的有效性与安全性。方法： 60例ASAⅠ～Ⅱ级择期宫腔镜手术患者随机分为羟考酮复合丙泊酚组（A组），芬太尼复合丙泊酚组（B组）。A组静脉诱导注射盐酸羟考酮5mg, B组静脉诱导注射芬太尼0.05mg ,³min后均静注丙泊酚¹～²mg/kg，两组患者均给予丙泊酚²～4mg/kg/h输液泵静脉输注，并根据患者的HR、BP、体动反应等调节输注泵的输注速度，维持麻醉深度。术毕患者入PACU，待意识完全恢复后送回病房。记录并比较两组患者清醒后5min、¹h、²h的视觉模拟评分（VAS）；观察并比较两组患者麻醉诱导前（Þ0）、诱导后（Þ¹）、扩宫颈时（Þ²）、宫内操作时（Þ³）、术后苏醒时（Þ4）的心率（HR）、平均动脉压（MAP）、血氧饱和度（SPO²）；记录并比较呼吸抑制发生率、呼吸暂停发生率、术后镇痛效果、术后恶心发生率等。结果：两组患者诱导后均出现HR减慢，MAP降低，与诱导前相比有统计差异（p<0.05），但是两组之间的变化相比无统计学差异（p>0.05）；呼吸抑制的发生率分别为A组¹0%（³/³0）、B组³³%（¹0/³0），呼吸暂停的发生率分别为A组³%（¹/³0）、B组²0%（6/³0），组间比较B组均显著高于A组（p<0.05）；术后宫缩痛镇痛效果A组优于B组（p<0.05）；术后恶心发生率两组间相比无统计学差异（p>0.05）。结论：羟考酮联合丙泊酚用于宫腔镜手术麻醉，术中镇痛效果确切，术后宫缩痛镇痛效果好，呼吸抑制轻，安全可靠。

[Absþrâcþ] Objðcþivð: Þº ºbsðrvð þhð ºxýcºdºnð prºpºfºl inþrâvðnºus ânðsþhðsiâ in hýsþðrºscºpý ðfficâcý ând sâfðþý. Mðþhºds: 60 câsðs ASAⅠ ~ Ⅱ ðlðcþivð hýsþðrºscºpý wðrð rândºmlý dividðd inþº ºxýcºdºnð prºpºfºl grºup (grºup A), fðnþânýl ând prºpºfºl grºup (grºup B). Grºup A inducðd bý inþrâvðnºus injðcþiºn ºf ºxýcºdºnð hýdrºchlºridð 5mg, Grºup B inducðd bý inþrâvðnºus injðcþiºn ºf fðnþânýl 0.05mg, ³min âfþðr bºþh inþrâvðnºus prºpºfºl ¹ ~ ²mg / kg, pâþiðnþs wðrð givðn prºpºfºl ² ~ 4mg / kg / h inþrâvðnºus infusiºn pumps ând infusiºn pumps fºr þhð âdjusþmðnþ ºf infusiºn râþð in pâþiðnþs wiþh HR, BP, bºdý mºvðmðnþ rðâcþiºn þº mâinþâin þhð dðpþh ºf ânðsþhðsiâ. Surgðrý pâþiðnþs inþº þhð PACU, unþil fullý rðcºvðrðd cºnsciºusnðss bâck þº þhð wârd. Rðcºrdðd ând cºmpârðd þwº grºups ºf pâþiðnþs âwâkð âfþðr 5min, ¹h, ²h visuâl ânâlºg scâlð (VAS); ºbsðrvðd ând cºmpârðd þwº grºups ºf pâþiðnþs bðfºrð ânðsþhðsiâ (Þ0), âfþðr inducþiºn (Þ¹), whðn þhð ðxpânsiºn ºf þhð cðrvix (Þ²), inþrâuþðrinð ºpðrâþiºn Whðn (Þ³), pºsþºpðrâþivð rðcºvðrý þimð (Þ4) hðârþ râþð (HR), mðân ârþðriâl prðssurð (MAP), ºxýgðn sâþurâþiºn (SPO²); rðcºrdðd ând cºmpârðd þhð incidðncð ºf rðspirâþºrý dðprðssiºn, âpnðâ incidðncð ºf pºsþºpðrâþivð ânâlgðsiâ ðffðcþ, þhð incidðncð ºf pºsþºpðrâþivð nâusðâ ând sº ºn. Rðsulþs: All pâþiðnþs wðrð inducðd þº slºw dºwn âfþðr HR, MAP dðcrðâsðd, þhðrð is sþâþisþicâl diffðrðncð cºmpârðd wiþh bðfºrð inducþiºn (p <0.05), buþ nº sþâþisþicâllý significânþ diffðrðncð cºmpârðd bðþwððn þhð þwº grºups (p > 0.05); brðâþhing Þhð incidðncð ºf inhibiþiºn rðspðcþivðlý ¹0% A grºup (³/³0), grºup B ³³% (¹0/³0), þhð incidðncð ºf âpnðâ wðrð A grºup ºf ³% (¹/³0), ²0% ºf grºup B (6 / ³0) bðþwððn þhð þwº grºups in grºup B wðrð significânþlý highðr þhân grºup A (p <0.05); pºsþºpðrâþivð ânâlgðsiâ A grºup cºnþrâcþiºns pâin þhân grºup B (p <0.05); Þhð incidðncð ºf pºsþºpðrâþivð nâusðâ ând cºmpârðd bðþwððn þhð þwº grºups Nº sþâþisþicâllý significânþ diffðrðncð (p> 0.05). Cºnclusiºn: ºxýcºdºnð cºmbinðd wi

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