右美托咪定复合地佐辛在经阴道穿刺取卵术中的临床评价

Evaluation of Dexmedetomidine combined with Dezocine in transvaginal ultrasound-guided oocyte retrieval

目的观察右美托眯啶复合地佐辛静脉麻醉用于经阴道超声引导下穿刺取卵术的临床效果和安全性。方法选择行经阴道超声引导下穿刺取卵术患者100例,采州随机数字表法将患者分为A组(采用有美托咪啶复合地佐辛麻醉)44例,B组(采用丙泊酚复合瑞芬太尼麻醉)56例。记录麻醉诱导前1 min(T0)、诱导完毕即刻(T1)、穿刺取卵进针后即刻(T2)、进针后3 min(T3)、手术结束清醒时(T4)的平均动脉压、心率、呼吸频率和血氧饱和度及苏醒时间、离室时间、手术时间、患者与术者的满意度及各种不良反应。结果两组平均动脉压和心率在T1和T4时点差异有统计学意义(P<0.05),A组较B组更平稳;T1-T4时点A组患者血氧饱和度和呼吸频率高于B组(P<0.05);两组手术时间差异无统计学差异(P>0.05);A组患者苏醒时间和离室时间短于B组(P<0.05),且患者及手术操作者满意度均高于B组(P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论两种麻醉方案均可满足取卵手术无痛麻醉的要求,右美托咪啶复合地佐辛麻醉方案患者呼吸抑制发生率更低,血流动力学更稳定,苏醒快速且平稳,患者与术者的满意度更高。

Objective To explore the clinical effect and safety of Dexmedetomidine combined with Dezocine in transvaginal ultrasound-guided oocyte retrieval. Methods 100 patients who accepted transvaginal ultra- sound-guided oocyte retrieval had been randomly divided into two groups according to intravenous anesthetic methods, group A （Dexmedetomidine combined with Dezocine, n=44 cases）, group B （Propofol intravenous injection, n=56 cases）. Mean arterial pressure （MAP）, heart rate （HR）, respiratory rate （RR） and pulse oxygen saturation of blood （SpO2） were recorded at the time when patients entering the operation room（T0）, immediately after induction being completed （T1）, beginning of inserting the needle（T2）, 3 minutes after puncturing the eggs （T3） and the end of the operation （T4）. Assessment on the analgesic effect, and the duration of oocyte retrieval, anesthesia recovery, patients satisfaction degree and adverse reactions were compared. Results The MAP and HR between two groups at T1 and T4 had significant difference （P 〈 0.05）. Group A is more stable than group B. Compared with group B, SpO2 and RR are significantly higher in group A （P 〈 0.05） at T1-T4. There was no difference in the duration of operation （P 〉 0.05）. Anesthesia recovery in group A is shorter than group B （P 〈 0.05 ）, and satisfaction of patients and surgical operator in group A were higher than group B （P 〈 0.05）. The adverse reactions rates of the two groups were not statistically significant （P 〉 0.05）. Conclusion There were similar in analgesic effect during oocyte retrieval between groups. Dexmedetomidine combined with Dezocine can achieve lower incidence of respiratory inhibition, more stable hemodynamics, faster and smoother wake up, the higher satisfaction of patients and surgeon.