静脉麻醉辅以口咽通气道通气应用于宫腔镜电切术的临床观察

Application of intravenous anesthesia in combination with oropharyngeal airway ventilation in hysteroscopy

目的 比较两种不同静脉麻醉方式复合口咽通气道通气应用于宫腔镜黏膜下肌瘤电切术的麻醉效果及安全性.方法 美国麻醉师协会（ASA）Ⅰ～Ⅱ级需宫腔镜电切术患者40例,年龄31 ～46岁,随机数字表法将患者分为两组：苏芬太尼组（A组,n=20）,右旋美托咪啶组（B组,n=20）.观察比较两组患者围术期血流动力学变化、丙泊酚总用量、麻醉苏醒时间、呼吸抑制程度、苏醒期躁动发生率、术后宫缩痛评分.结果 B组T2时间点的SBP、HR值均高于A组,具有统计学意义（P＜0.05）.且B组的苏醒时间短于A组,亦具有统计学意义（P＜0.05）.但是A、B两组在丙泊酚使用量、术后镇痛效果以及呼吸抑制、苏醒期躁动发生率等方面的差异均无统计学意义（P＞0.05）.结论 两种不同静脉麻醉方式用于宫腔镜电切术均取得看良好的麻醉效果,不良反应较少,但是使用低剂量右旋美托咪啶,患者的血流动力学更稳定,苏醒时间更短.

Objective To observe the safety and efficiency of two different ways of intravenous anesthesia combined with oropharyngeal airway ventilation in hysteroscope operation.Methods 40 ASA Ⅰ ～ Ⅱ patients undergoing hysteroscopy were randomly assigned into two groups,20 cases in each group.Patients in the group A,B,were administered respectively with sufentanil 0.1 μg/kg or dexmedetomidine 0.5μg/kg by micro-pump in at least 10 minutes before operation.The perioperative hemodynamic index was recorded.The different outcomes including total dose of propofol,hemodynamic changes,recovery time,postoperative uterine contraction pain and episodes of adverse actions were observed and compared.Results Compared with group A,heart rate （HR） and systolic blood pressure （SBP） were higher in group B （P ＜ 0.05）.The recovery time in group A was longer than that in group B （P ＜0.05）.But there were no statistical differences of the total dosage of propofol,the incidence of respiratory depression,and the incidence rate of drowsiness after operation betwween group A and group B （P ＞ 0.05）.Conclusion There was safe and effective of two different ways of intravenous anesthesia combined with oropharyngeal airway ventilation in hysteroscope operation,but the dynamic index was more stable,and the recovery time was shorter in patients with lowdose dexmedetomidine.