宫颈旁阻滞复合阿芬太尼全凭静脉麻醉在宫腔镜日间手术中的应用

Application of paracervical block combined with alfentanil in hysteroscopic day surgery under total intravenous anesthesia

目的探讨宫颈旁阻滞复合阿芬太尼全凭静脉麻醉在宫腔镜日间手术中的有效性和安全性。方法采用前瞻性随机对照研究的方法,随机选取潍坊市人民医院2020年10月-12月收治的60例需在全身麻醉下行宫腔镜手术治疗的日间手术患者,所有患者采用完全随机数字表法分为试验组和对照组,每组30例。试验组接受宫颈旁阻滞复合阿芬太尼全凭静脉麻醉,对照组接受阿芬太尼全凭静脉麻醉,比较两组患者的一般情况、手术时长、苏醒时间、术中丙泊酚用量、术后疼痛评分、术中体动反应和术后恶心呕吐发生率差异。结果两组患者的年龄、体质量指数、合并症发生率差异无统计学意义(P>0.05)。两组患者的手术时长、苏醒时间、术后2 h时疼痛评分、恶心呕吐发生率差异无统计学意义(P>0.05)。对照组的丙泊酚用量[(34.07±12.67)vs.(28.33±9.10)mL]、苏醒时疼痛评分[(1.50±0.78)vs.(0.77±0.50)分]和体动反应发生率(20.0%vs.0.0%)高于试验组(P<0.05)。结论宫腔镜日间手术中采用宫颈旁阻滞复合阿芬太尼全凭静脉麻醉的方法可减少术中丙泊酚用量,降低术后疼痛,同时减少围手术期不良反应,具有较好的有效性和安全性。

Objective To investigate the efficacy and safety of paracervical block combined with alfentanil in hysteroscopic day surgery under total intravenous anesthesia.Methods This study used a prospective randomized controlled study approach.A total of 60 day surgery patients requiring hysteroscopic surgery under general anesthesia admitted to Weifang People’s Hospital between October and December 2020 were randomly selected.All patients were divided into trial group and control group by completely random number table method,with 30 patients in each group.The trial group received paracervical block combined with total intravenous anesthesia with alfentanil,and the control group received total intravenous anesthesia with alfentanil.The general condition,operation time,recovery time,intraoperative propofol dosage,postoperative pain score,intraoperative motion response and postoperative nausea and vomiting incidence were compared between the two groups.Results There was no significant difference in age,body mass index and incidence of comorbidities between the two groups(P>0.05).There was no significant difference in the operation time,recovery time,pain score at 2 hours after operation,and incidence of nausea and vomiting between the two groups(P>0.05).In the control group,the dose of propofol[(34.07±12.67)vs.(28.33±9.10)mL],the pain score on awakening(1.50±0.78 vs.0.77±0.50),and the incidence of body movement response(20.0%vs.0.0%)were higher than the trial group(P<0.05).Conclusion The use of paracervical block combined with alfentanil in hysteroscopic day surgery under total intravenous anesthesia can reduce the amount of propofol during the operation,reduce postoperative pain,and reduce perioperative adverse reactions,which has a good efficacy and safety.