丙泊酚联合丁卡因麻醉在取卵术中的应用及对IVF-ET结局的影响

The application of propofol combined with tetracaine in ovum extraction and its effect on IVF-ET outcome

目的 探讨丙泊酚静脉麻醉联合丁卡因局部麻醉的复合麻醉方式在取卵术中的应用效果及对体外受精-胚胎移植(IVF-ET)结局的影响。方法 选取本院2020年1月-2020年6月首次接受IVF-ET助孕技术行无痛取卵术的患者共200例,依据随机化原则将入选患者依据不同的麻醉方式分为两组,试验组:丙泊酚静脉麻醉联合丁卡因局部麻醉;对照组:单纯丙泊酚静脉麻醉。分析两组患者丙泊酚用量、麻醉时间、苏醒时间、术后0.5h疼痛评分、麻醉不良反应、患者对麻醉的满意度评分及IVF-ET的临床结局。结果 试验组的丙泊酚用量(mg)要低于对照组(162.58±22.12 VS 245.32±50.45,P <0.05)、试验组的麻醉时间(min)少于对照组(14.22±5.10 VS 17.35±5.15,P <0.05)、苏醒时间(min)差异无统计学意义(2.11±1.01VS 1.86±0.82,P> 0.05),试验组术后0.5 h疼痛评分低于对照组意义(1.05±1.15 VS 4.49±1.02,P <0.05),麻醉不良反应发生率差异无统计学意义(P> 0.05),试验组的麻醉满意度评分高于对照组(9.72±3.21 VS 9.05±2.87,P <0.05),两组患者的获卵数、受精率、优胚率、临床妊娠率差异均无统计学意义(P> 0.05)。结论 丙泊酚静脉麻醉丁卡因可以减少丙泊酚的用量、缩短麻醉时间和苏醒时间,并能明显缓解术后疼痛,目前临床结果显示对患者的IVF-ET的结局无影响。

Objective To investigate the effect of propofol intravenous anesthesia combined with local tetracaine anesthesia in oocyte retrieval and its effect on IVF-ET outcome. Methods A total of 200 patients who received IVF-ET assisted fertility technology for painless oocyte retrieval for the first time in our hospital from January 2020 to June 2020 were selected. The enrolled patients were divided into two groups randomly according to different anesthetic methods. Experimental group were treated with propofol intravenous anesthesia combined with local tetracaine anesthesia, while control group were treated with simple propofol intravenous anesthesia. The dosage of propofol, anesthesia time, recovery time, postoperative pain score at 0.5h after operation, adverse reactions, satisfaction degree of patients to anesthesia and the clinical outcome of IVF-ET in two groups were analyzed. Results The dosage of propofol in experimental groups was lower than that in control group(162.58±22.12 vs 245.32±50.45, P < 0.05), the anesthesia time(min)in experimental groups was lower than that in control group(14.22±5.10 vs 17.35±5.15, P < 0.05), and the recovery time(min)had no significant difference(2.11±1.01 vs 1.86±0.82, P > 0.05).Pain score at 0.5 h after operation in the experimental group was lower than that of control group(1.05 +/-1.15 vs 4.49 +/-1.02, P < 0.05). There was no statistically significant difference about the incidence of adverse reactions to anesthesia(P > 0.05). Satisfaction degree of the experimental group was higher than that of the control group(9.72 +/-3.21 vs 9.05 +/-2.87, P < 0.05). The number of eggs, fertilization rate, optimal rate and clinical pregnancy rate of two groups had no statistically significant differences(P > 0.05). Conclusion Intravenal propofol anesthesia combined with tetocaine can reduce the dosage of propofol, shorten the time of anesthesia and recovery time, and significantly relieve postoperative pain. The current clinical results show that there is no adverse effect on the outcome of IVF-ET in patients.