丙泊酚、芬太尼复合小剂量咪唑安定静脉麻醉在妇产科门诊手术中的应用效果

The application effect of propofol, fentanyl combined with low-dose midazolam intravenous anesthesia applied in obstetrics and gynecology clinic surgery

目的分析丙泊酚注射液、芬太尼与小剂量咪唑安定三种麻醉药物在妇产科门诊手术中的麻醉效果。方法选取我院妇产科门诊的60例患者作为研究对象,将其随机分为PF组和PFM组,每组30例。PF组使用丙泊酚复合芬太尼进行麻醉;PFM组在PF组的基础上加用小剂量咪唑安定进行麻醉。监测记录两组患者不同时间段的平均动脉压(MAP)、心率(HR)、呼吸(RR)以及脉搏血氧饱和度(Sp O_2),并观察两组患者麻醉的药物起效时间、手术时间、苏醒时间及丙泊酚用量情况和不良反应发生情况。结果两组患者麻醉后的MAP、HR、RR及Sp O_2的最低值明显低于麻醉前(P<0.05);手术结束后PF组RR、Sp O_2值明显低于PFM组(P<0.05);两组患者的麻醉起效时间、苏醒时间,组间比较无明显差异(P>0.05);PFM组的丙泊酚用量明显低于PF组(P<0.05);两组患者的术中体动、术后嗜睡、乏力、头晕、恶心、呕吐等不良反应发生率比较,无明显差异(P>0.05)。结论丙泊酚+芬太尼+小剂量咪唑安定用于妇产科门诊的麻醉手术相比丙泊酚+芬太尼麻醉效果更佳,风险更低。

Objective To investigate the anesthetic effect of propofol, fentanyl combined with low-dose midazolam intravenous anesthesia applied in obstetrics and gynecology outpatient surgery. Methods Sixty patients were selected in department of obstetrics and gynecology of our hospital, and were randomly divided into group PF and group PFM, with 30 cases in each group. Group PF was given propofol combined with fentanyl, while group PFM received propofol, fentanyl combined with low-dose midazolam intravenous anesthesia on the basis of group PF. The mean arterial pressure （MAP）, heart rate （HR）, respiration （RR） and pulse oxygen saturation （SpOz） were recorded in two groups with different time periods. The onset time, operation time, recovery time, the dosage of propofol and adverse reactions of the two groups were observed. Results The lowest values of MAP, HR, RR and SpO2 in the two groups after anesthesia were lower than before anesthesia （P〈0.05）. After operation, the values of RR, SpO2 in PF group were significantly lower than those in PFM group （P〈0.05）. The onset time and recovery time of anesthesia in the two groups were not statistically significant （P〉0.05）; the dosage of propofol in PFM group was significantly lower than that in PF group （P〈O.05）. There were no significant differences of the incidence rate of body movement in intra-operative and adverse reactions such as drowsiness, fatigue, dizziness, nausea, vomiting in post-operative between the two groups （P〉0.05）. Conclusion Compared with propofol and fentanyl anesthesia, the therapeutic effect of anesthesia with propofol, fentanyl and low-dose midazolam for obstetrics and gynecology is better and with less risk.