舒芬太尼联合咪达唑仑在经阴道B超引导卵巢囊肿穿刺硬化治疗中的应用效果探讨

Application effect of sufentanil combined with midazolam in puncture sclerosis treatment of ovarian cyst guided by transvaginal B-ultrasound

目的:探讨舒芬太尼联合咪达唑仑在经阴道B超引导卵巢囊肿穿刺硬化治疗中的可行性及安全性。方法:选取2016-11~2017-12我院妇产科门诊行经阴道B超引导卵巢囊肿穿刺硬化治疗术的患者126例,随机分为A组和B组,每组各63例。A组静脉注射舒芬太尼联合咪达唑仑,B组静脉注射舒芬太尼联合丙泊酚。记录患者麻醉前、术中不同时点的平均动脉压、心率、血氧饱和度;统计两组麻醉后3 min(T1)出现血压<90/60 mmHg、心率<60/min、SpO2<90%的例数;记录患者的离院时间及手术医生、患者的麻醉满意度。结果:与B组比较,A组的麻醉方法对循环和呼吸影响更小(P<0.05),且A组的离院时间明显缩短(P<0.01)。A组T1时点出现血压<90/60mmHg,心率<60/min,SpO2<90%的例数少于B组。两组手术医生的麻醉满意度和患者的麻醉满意度无明显差异(P>0.05)。结论:将舒芬太尼与咪达唑仑联合应用在经阴道B超引导卵巢囊肿穿刺硬化治疗中,可以取得良好的麻醉效果,且对患者的循环和呼吸影响更小。

Objective：To investigate the feasibility and safety of sufentanil combined with midazolam in puncture sclerosis treatment of ovarian cysts guided by transvaginal B-ultrasound.Methods：A total of 126 patients undergoing puncture sclerosis treatment of ovarian cyst guided by transvaginal B-ultrasound were randomly divided into group A and group B,63 cases in each group.Group A was given sufentanil comined with midazolam,and group B was given sufentanil combined with propofol.The mean arterial pressure（MAP）,heart rate（HR）and oxyhemoglobin saturation were recorded at different time points,and the number of patients with blood pressure below 90/60 mmHg,HR less than 60/min,and SpO2 less than90% were recorded at T1 time point in two groups,and the time of leave hospital,anesthetic satisfaction of the surgeon and patients was recorded.Results：Compared with group B,group A had less effect on circulation and respiration（P〈0.05）.The time of leave hospital in group A was significantly shorter than that in group B（P〈0.01）.Patients with blood pressure below90/60 mmHg,HR less than 60/min,and SpO2 less than 90% during three minutes after anesthesia in group A was less than group B.There was no significant difference in anesthesia satisfaction of surgeon and patients between the two groups（P 0.05）.Conclusion：The combination of sufentanil and midazolam in puncture sclerosis treatment of ovarian cyst guided by transvaginal B-ultrasound can obtain the great anesthesia effect and has less effect on circulation and respiration.