宫腔镜电切术麻醉方式的探讨

Study on the style of anesthesia in hysteroscopic surgery

目的：探讨宫腔镜电切术中麻醉方式的选择，比较静脉复合麻醉与硬膜外麻醉在宫腔镜电切术中的应用效果。方法：宫腔镜电切500例应用异丙酚、芬太尼静脉复合麻醉，10例采用硬膜外麻醉。观察BP、HR、PP、SpO2、病人入睡时间、睁眼时间以及病人术后感觉、能自由活动时间。结果：静脉复合麻醉对呼吸有一定抑制作用，但均在正常范围。病人入睡时间（24．8±5．2）s．睁眼时间（4．74±3．32）min。全部病人对手术经过均无痛苦回忆。硬膜外麻醉自穿刺到用药后起效约需（30—40）min。术后需平卧6h。结论：静脉复合麻醉用于宫腔镜电切术，具有操作简便、起效迅速、镇痛效果好、安全性高等优点，值得临床推广应用。而硬膜外麻醉准备时间长，起效慢，术后恢复慢。但对估计手术时间超过60min者，选择硬膜外麻醉具有优势。

Objective： To study on the style of anesthesia in hysteroscopic surgery and compare effectiveness between balanced ,anesthesia and epidural anesthesia. Mcthod：Propofolum and fentanyl were used in 500 cases by balanced anesthesia,and 10 cases by epidural anesthesia. To observe BP,HR,SPO2,the time of falling asleep,the time of eyes oopen,the feeling after operating and th e time for free-running. Results： Inhibitory action on breath was found in the cases by balanced anesthesia,but all in the normal limits.The time of falling asleep was 24.8±5.2s,and time of eyes open was 4.74±3.32min.All the patients had no no complaints.The cases by epidural anesthesia need 30-40min to be effective,and the patients must prostrate 6 hours after operating. Conclusion： The balanced anesthesia has many merits when it is used in the hysteroscopic surgery ,so it can be generalizated in clinic. Epidural anesthesihas ascendancy in the operation long than 60 min.