地佐辛复合七氟烷吸入麻醉在宫腔镜电切术中的应用

Application of dezocine and sevoflurane inhalation anesthesia in hysteroscope electrotomy

目的探讨地佐辛与舒芬太尼用于宫腔镜电切术麻醉的临床效果。方法选择宫腔镜电切术患者30例（ASAI～Ⅱ级），随机分为地佐辛＋七氟烷组（A组）和舒芬太尼＋七氟烷组（B组），每组15例。手术操作前10minA组一次性匀速泵注地佐辛1．5μg/kg，B组一次性匀速泵注舒芬太尼0．15μg／kg，两组注药时间均持续5min，均以诱导浓度为5％七氟烷和5IVmin氧流量快速诱导，待患者意识消失后用2％七氟烷和3L／min氧流量吸入维持麻醉，记录麻醉开始前（To）、吸入麻醉后2min（T1）、扩宫颈时（T2）、术毕清醒时（T3）、清醒后5min（T4）时平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2），记录麻醉起效时间、意识恢复时间、术中体动和呼吸抑制情况；观察术后清醒时间、VAS评分及不良反应情况。结果T0、T1、T3两组MAP、Sp02比较差异无统计学意义（P〉0．05），B组T2时MAP、HR与A组比较差异有统计学意义（P〈0．05），A组术中体动发生率明显少于B组（P〈0．05），A组清醒时间明显短于B组（P〈0．05），A组术后宫缩痛、恶心呕吐发生率明显少于B组（P〈0．05）。结论地佐辛或舒芬太尼复合七氟烷吸入用于宫腔镜电切术麻醉效果相似，但地佐辛复合七氟烷吸入用于宫腔镜电切术麻醉效果更佳。

Objective To investigate the clinical effect of dezocine and sufentanil anesthesia on hysteroscopic electrotomy. Methods Thirty patients with hysteroscope electrotomy（ASA Ⅰ - Ⅱ stage） were randomly divided into dezocine ＋ sevoflurane group （ group A） and sufentanil ＋ sevoilurane group （group B）, 15 cases in each group. Ten minutes before the operative procedure, dezocine 1.5 μg/kg was pumped with an equal speed in group A, and sufentanil 0. 15 μg/kg was pumped with an equal speed in group B, the injection times lasted for 5 min, were rapidly induced with concentration 5% sevoflurane and 5 L/min oxygen flow, until the patient lost consciousness, was maintained with 2% sevoflurane anesthesia and oxygen flow 3 L/min. MAP, HR, SpO2 was recorded before the start of anes- thesia（T0）, 2 min after inhalation anesthesia （TI）, expanding the cervix （T2 ）, awake after surgery （ T3 ）, 5 rain after awake （ T4 ） , and the onset time of anesthesia, consciousness recovery time, intraoper- ative body movement and respiratory inhibition, intraoperative VAS score after the awake time and ad- verse reactions were observed. Results There were no significant differences in MAP, SpO2 at To, T~, T3 between the two groups（ P 〉 0. 05 ） ; There were significant differences in MAP, HR at T2 between the two groups （P 〈 0. 05 ） ; Intraoperative body movement was significantly less in group A than that in group B （ P 〈 0. 05 ）, the recovery time was significantly shorter in group A than that in group B （ P 〈 0. 05 ） ; The postoperative uterine pain, incidence of nausea and vomiting was significantly less than that in group B （P 〈 0. 05）. Conclusions Dezocine with sufentanil sevoflurane anesthesia for hysteroscopic resection has similar effect, but dezocine combined with sevoflurane anesthesia for hysteroscopie surgery is better.