右美托咪定复合依托咪酯对妇科宫腔镜检查麻醉中的效果观察及安全性分析

The Effect and Safety Analysis of Dexmedetomidine combined with Etomidate in Anesthesia of Gynecological Hysteroscopy

目的探讨分析妇科宫腔镜检查麻醉中右美托咪定复合依托咪酯的临床效果和安全性。方法选取2019年11月至2020年6月在院妇科就诊的宫腔镜检查患者80例作为研究对象,采用随机数表法将患者分为观察组(n=40)和对照组(n=40)。对照组采用依托咪酯,观察组采用右美托咪定复合依托咪酯。比较各时间点对照组和观察组患者的平均动脉压(MAP)、心率(HR)以及血氧饱和度(SpO2)和依托咪酯用量、可唤醒时间以及不良反应发生情况。结果术前(T0)、注射右美托咪定或安慰剂后即刻(T1)、注射依托咪酯后(T2)、宫腔内操作时(T3)、检查结束时(T4)对照组和观察组MAP、HR以及SpO2均没有显著差异(P>0.05);对照组和观察组依托咪酯用量、可唤醒时间比较,观察组均显著较少或较短(P<0.05);烦躁、恶心、疼痛以及头晕等不良反应发生率和对照组比较分析,观察组发生率均显著较低,对照组不良反应发生率为35.00%,观察组不良反应发生率为10.00%(P<0.05)。结论妇科宫腔镜检查麻醉中应用右美托咪定复合依托咪酯的临床效果显著,有效稳定了MAP、HR以及SpO2,减少了依托咪酯用量,缩短了可唤醒时间,降低了不良反应发生率,值得临床推广使用。

Objective To investigate the clinical effect and safety of dexmedetomidine combined with etomidate in gynecological hysteroscopy.Methods From November 2019 to June 2020,80 cases of hysteroscopy patients were selected as the study object.The patients were divided into the observation group(n=40)and the control group(n=40)by the random number table method.Etomidate was used in the control group and etomidate was used in the observation group.The mean arterial pressure(map),heart rate(HR),blood oxygen saturation(SpO2),etomidate dosage,wake-up time and adverse reactions were compared between the control group and the observation group.Results There was no significant difference in map,HR and SpO2 between the control group and the observation group before operation(T0),immediately after injection of dexmedetomidine or placebo(T1),immediately after injection of etomidate(T2),intrauterine operation(T3),and at the end of examination(T4).There was no significant difference in map,HR and SpO2 between the control group and the observation group(P>0.05).There was no significant difference in etomidate dosage and wake-up time between the control group and the observation group(P<0.05).There was no significant difference between the observation group and the observation group(P<0.05)Compared with the control group,the incidence of adverse reactions such as manic,nausea,pain and dizziness was significantly lower in the observation group,35.00%in the control group and 10.00%in the observation group(P<0.05).Conclusion The clinical effect of dexmedetomidine combined with etomidate in gynecological hysteroscopy anesthesia is significant,which can effectively stabilize map,HR and SpO2,reduce the dosage of etomidate,shorten the wake-up time,reduce the incidence of adverse reactions,and is worthy of clinical application.