依托咪酯、丙泊酚联合芬太尼应用于宫腔镜手术的对比观察

Comparison of the Effects between Etomidate and Propofol with Fentanyl Anaesthesia for Hysteroscopic Surgery

目的研究依托咪酯、丙泊酚联合芬太尼应用于宫腔镜手术的安全性和有效性.方法 80例ASAⅠ～Ⅱ级行宫腔镜手术的患者随机分为两组,每组40例.两组患者静脉注射芬太尼10μg/kg,随后丙泊酚组(P组)静脉推注丙泊酚1.5～2.0 mg/kg后以0.08～0.12 mg/(kg.min)持续输注;依托咪酯组(E组)静脉推注依托咪酯0.30～0.35 mg/kg后以10～15μg/(kg.min)持续输注.记录麻醉效果、不良反应、生命体征等.结果两组患者VAS评分和满意度相似(P>0.05),不良反应发生率相近(P>0.05),P组平均动脉压和心率在T1、T2时刻较E组及本组基础值降低(Ρ<0.01),SpO2≤90%发生例数高于E组(Ρ<0.01).结论依托咪酯联合芬太尼运用于宫腔镜手术镇痛效果完善,安全性好,值得临床推广运用.

Objective To compare the safety and feasibility of etomidate and propofol with fentanyl and propofol （1.5 -2 mg/kg） , then propofol 0.08 - 0.12 mg/（kg.min） was slowly injected intravenously. In group E （n = 40） , patients were injected a dose of fentanyl （10 μg/kg） and etomidate （0.30 - 0.35 mg/kg） and then received etomidate 10 - 15 μg/（kg.min） intravenously. Antalgic effect, side effects and vital signs were recorded. Results There was no difference in VAS scores, satisfaction of the patients and side effects between the two groups （P 〉 0.05 ）. Compared with group E, MAP and HR in group P decreased significantly at T1 and T2 （P 〈 0.01） , and the incidence of respiratory depression was higher （P 〈 0.01 ）. Conclusions Etomidate with fentanyl anaesthesia is safe and has better analgesic effect in the hysteroscopic surgery. Therefore, it is worth extending in clinic practice.