艾司氯胺酮与舒芬太尼联合丙泊酚用于宫腔镜手术麻醉效果比较

Comparison of Anesthetic Effects of Esketamine Combined with Propofol and Sufentanil Combined with Propofol in Hysteroscopy

目的比较艾司氯胺酮与舒芬太尼联合丙泊酚用于宫腔镜手术的麻醉效果。方法选取医院2022年1月至4月择期行宫腔镜手术的患者60例,按随机数字表法分为艾司氯胺酮+丙泊酚组(K组)和舒芬太尼+丙泊酚组(S组),各30例。麻醉开始时,K组患者静脉注射艾司氯胺酮0.2 mg/kg,S组患者静脉注射舒芬太尼1.5µg/kg,均持续泵入丙泊酚1.5 mg/kg。结果与S组比较,K组患者睫毛反射消失时(T_(1))、扩宫时(T_(2))的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_(2))均显著更高(P<0.05)。K组患者的丙泊酚用量为(13.58±7.05)mg/(kg•h),低于S组的(17.63±6.84)mg/(kg•h),差异显著(P<0.05);K组患者的丙泊酚总用量为125(110,130)mg,显著低于S组的185(170,200)mg(P<0.05);K组患者的丙泊酚追加率为16.67%,显著低于S组的53.33%(P<0.05)。K组患者呼吸抑制和严重体动发生率分别为3.33%和10.00%,分别显著低于S组的26.67%和36.67%(P<0.05)。结论与舒芬太尼比较,艾司氯胺酮联合丙泊酚用于宫腔镜手术麻醉效果更好,患者血流动力学平稳,呼吸抑制轻微,且安全性较好。

Objective To compare the anesthetic effects of esketamine combined with propofol and sufentanil combined with propofol in hysteroscopy.Methods A total of 60 patients planned for hysteroscopy admitted to the hospital from January to April 2022 were selected and divided into the esketamine+propofol group(group K)and sufentanil+propofol group(group S)by the random number table method,with 30 cases in each group.At the beginning of anesthesia,the patients in the group K were given the intravenous injection of 0.2 mg/kg of esketamine,while the patients in the group S were given the intravenous injection of 1.5µg/kg of sufentanil.Both groups were continuously pumped with 1.5 mg/kg of propofol.Results Compared with those in the group S,the mean arterial pressure(MAP),heart rate(HR)and pulse oxygen saturation(SpO_(2))at the time of eyelash reflex disappearance(T_(1))and uterus dilatation(T_(2))in the group K were significantly higher(P<0.05).The dosage of propofol in the group K was(13.58±7.05)mg/(kg•h),which was significantly less than(17.63±6.84)mg/(kg•h)in the group S(P<0.05).The total dosage of propofol in the group K was 125(110,130)mg,which was significantly less than 185(170,200)mg in the group S(P<0.05).The additional rate of propofol in the group K was 16.67%,which was significantly lower than 53.33%in the group S(P<0.05).The incidence of respiratory depression and serious body movement in the group K was 3.33%and 10.00%respectively,which was significantly lower than 26.67%and 36.67%in the group S respectively(P<0.05).Conclusion Compared with sufentanil combined with propofol,the anesthetic effect of esketamine combined with propofol is more effective in the hysteroscopy,with stable hemodynamics,slight respiratory depression and good safety.