氯诺惜康或芬太尼复合丙泊酚静脉麻醉用于宫腔镜手术临床观察

目的:比较氯诺惜康或芬太尼复合丙泊酚静脉麻醉用于宫腔镜手术的临床效果。方法:90例行宫腔镜手术的患者,随机均分为3组,分别在丙泊酚麻醉前5分钟静脉注射生理盐水10ml(P组)、芬太尼1.0μg/kg(F组)、氯诺惜康0.15mg/kg(L组)。记录各组手术时间、清醒时间、定向力恢复时间、丙泊酚用量;监测术中BP、HR、SPO2,观察术中及术后5、10、20、30分钟镇痛效果及不良反应。结果:L组清醒时间和定向力恢复时间显著短于F组和P组(P<0.05,P<0.01)。P组丙泊酚用量显著大于F、L组(P<0.05)。术中体动P组显著重于F、L组(P<0.05)。术后各时间点VAS评分F、L组均显著低于P组,而L组在术后20分钟、30分钟显著重低于F组(P<0.05,P<0.01)。术中低血压、心率减慢的发生率P组显著高于F、L组(P<0.05)。L组呼吸抑制和术后站立头发生率显著低于F、P组(P<0.01)。3组偶有恶心呕吐发生,组间比较差异无统计学意义。结论:氯诺惜康复合丙泊酚用于宫腔镜手术麻醉效果确切,丙泊酚用量少,不良反应轻,术后镇痛效果优且时效长,是安全有效的麻醉方法。

Objective：To compare the effect of propofol anesthesia with fentanyl or lornoxican in hysteroscope operative.Methods：Ninety patiens were randomly divided into three groups with 30 cases each,Normanl saline 10ml（group P）,fentanyl 1.0μg/kg（group F） or lornoxican 0.15mg/kg（group L） were injected 5 minutes before anesthesia introduction separatly.The operative time,wake-up time,orientation recovert time and the propofol dosage were recorded.Observing BP,HR,SPO2,analgesiac and adverse effects during intro-and post-operative at 5,10,20,30min.Results：The wake-up time and orientation recovert time were longer in group P than that in the others（P0.05,P0.01）.The dosage of propofol was larger in group P than in other groups（P0.05）.The body movement during operation were higher in group P than in other groups（P0.05）.VAS scores during post-operative of group P was higher than in other groups,and at 20,30 min was significantly lower in group L than group F（P0.05,P0.01）.Bp and HR decrease were higher in group P than other groups（P0.05） during intro-operative.The respiratory depression and post-operative vertigo were significantly lower in group L than other groups （P0.01）.Post-operative nauseaa and vomiting ocrurred ocasionaly in three groups.Conclusion：The anesthesia effect of propofol compound lornoxican are better without significant adverse effects.they can provide better and longer post-operative analgesia,and could be a better choice for hysteroscope operative.