地佐辛复合依托咪酯乳剂减轻宫腔镜取胚术中呼吸抑制的观察

Clinical observation on dezocine injection compounded by etomidate fat emulsion injection for reducing respiratory inhibition in hysteroscopic embryo collecting operation

目的：探讨地佐辛复合依托咪酯乳剂用于减轻宫腔镜取胚术中呼吸抑制的有效性和安全性。方法：随机选择ASAI～Ⅱ级早期妊娠且拟行宫腔镜取胚手术患者150例，随机均分为3组，每组50例。I组：地佐辛0．1mg·kg。“复合依托咪酯乳剂0．2mg·kg-1静脉全麻；1I组：芬太尼1／＊g·kg-1复合依托咪酯乳剂0．2mg·kg-1静脉全麻；Ⅲ组：舒芬太）gO1p-g·kg。复合依托咪酯乳剂0．2mg·kgll静脉全麻。观察比较麻醉诱导后患者循环系统变化，呼吸抑制发生率，苏醒时间及不良反应的发生率。结果：3组患者都顺利完成手术。Ⅲ组患者麻醉诱导后MAP、HR、SPO2较I、Ⅱ组明显降低（P（0．05）；呼吸抑制发生率l组明显低于Ⅱ、Ⅲ纽（P〈0．05）；苏醒时间及不良反应的发生率I组显著低于Ⅱ、Ⅲ组（P〈0，05）；术中镇痛不全的发生率3组无明显差异（P〉0．05）。结论：地佐辛复合依托咪酯乳剂用于宫腔镜取胚手术，镇痛效果确切，对呼吸、循环系统抑制小，不良反应发生率低，安全性和可控性高，值得广大临床工作者学习和推广。

OBIECTIVE To observe the effectiveness and safety of reducing respiratory inhibition in dezocine injection corn pounded by etomidate fat emulsion injection for painless hysteroscopic embryo collecting operation. METHODS cases of class ASA - Ⅱ with early pregnancy were randomly selected and divided into three groups, each group having 50 cases. Group I ： intravenous anesthesia hy applying 0.1 rag, kg of dezoeine injection compounded by 0. 2 g. kg i of etomidate fat e mulsion injection; Group ： intravenous anesthesia by applying kg-1 of fentanyl citrate injection compounded by 0. 2 mg . kg-1 of etomidate fat en-mlsion injection; Group intravenous aneshesia by applying sufentanil citrate injec tion compounded by 0.2 mg-kg i of etomidate fat emulsion injection. The changes in the circulatory system, the rate of occur rence of respiratory inhibition, time of regaining consciousness and the rate of occurrence of undesirable reactions of the patients after anaesthetic induction were observed and compared. RESULTS All the patients of the three groups completed the opera tion smoothly. MAP, HR, SPO2 of the patients in GroupⅢafter anaesthetic induction were significantly lower than those of the patients in Groups I and Ⅱ （P〈0. 05）. The rate of occurrence of respiratory inhibition of Group I was obviously lower than that of the groups Ⅱ and Ⅲ （P〈0. 05）. The time of regaining consciousness and the rate of occurrence of undesirable reactions of Group I were obviously lower than those of GroupsⅡ and Ⅲ（P〈0. 05）. In terms of the rate of occurrence of incomplete analgesia during the operation, there was no significant difference among the three groups （P〉0. 05）. CONCLUSION The ap plication of dezocine injection compounded by etomidate fat emulsion injection in the painless hysteroscopic embryo collecting operation had definite analgesic effect, little inhibition on the respiratory and circulatory systems, lower rate of occurrence of undesirable reactions, and higher safety and controllability, so it deserves being studied and popularized among the vast numbers of clinical workers.