布托啡诺预注射联合瑞马唑仑在宫腔镜手术治疗子宫内膜息肉中的应用研究

Application of butorphanol preinjection combined with remazolam in hysteroscopic surgery for endometrial polyps

目的探讨布托啡诺预注射联合瑞马唑仑在宫腔镜手术治疗子宫内膜息肉中的应用价值。方法前瞻性选取2022年1月至10月在仙桃市第一人民医院拟行宫腔镜下子宫内膜息肉摘除术患者102例,采用信封法将患者随机分为观察组(n=51)和对照组(n=51),两组均行宫腔镜下子宫内膜息肉摘除术,观察组给予布托啡诺预注射联合瑞马唑仑,对照组给予瑞马唑仑。观察比较两组血流动力学指标、麻醉起效时间、术后苏醒时间、疼痛评分,血清孕酮、促卵泡激素(FSH)及雌二醇水平,以及术中不良反应情况。结果观察组麻醉后5 min(T_(1))、扩宫即刻(T_(2))和术毕(T_(3))时平均动脉压(MAP)、心率明显高于对照组,差异均有统计学意义(P<0.05)。观察组麻醉起效时间和术后苏醒时间为(40.50±3.11)s、(3.50±1.02)min,明显低于对照组[(48.83±3.29)s、(5.01±1.12)min],差异均有统计学意义(P<0.05)。观察组术后6、12 h时视觉模拟法(VAS)疼痛评分为(2.65±0.76)、(2.02±0.65)分,低于对照组[(3.44±0.80)、(2.11±0.62)分],差异均有统计学意义(P<0.05)。观察组和对照组术后1周孕酮、FSH和雌二醇比较,差异均无统计学意义(P>0.05)。观察组和对照组术中体动、呼吸抑制及恶心呕吐发生率比较,差异无统计学意义(P>0.05);观察组呛咳发生率为0,明显低于对照组(23.53%),差异有统计学意义(P<0.05)。结论布托啡诺预注射联合瑞马唑仑在宫腔镜手术治疗子宫内膜息肉中有较好的麻醉效果,优于单用瑞马唑仑,可减轻患者术后疼痛,并减少不良反应发生。

Objective To investigate the application value of butorphanol pre injection combined with ramazolam in hysteroscopic surgery for endometrial polyps.Methods From January to October 2022,102 patients who were scheduled to undergo hysteroscopic endometrial polypectomy in Xiantao First People's Hospital were prospectively selected,the patients were randomly divided into the observation group(n=51)and the control group(n=51)by envelope method,both groups underwent hysteroscopic endometrial polypectomy,the observation group was given butorphanol preinjection combined with remazolam anesthesia,and the control group was given remazolam anesthesia.The hemodynamic parameters,onset time of anesthesia,postoperative recovery time,pain score,serum progesterone,follicle stimulating hormone(FSH),estradiol levels,and adverse reactions during surgery were observed and compared between the two groups.Results The mean arterial pressure(MAP)and heart rate at 5 minutes after anesthesia(T_(1)),immediately after dilatation(T_(2))and at the end of operation(T_(3))in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The onset time of anesthesia and recovery time after operation in the observation group were(40.50±3.11)s,(3.50±1.02)min,which were significantly lower than those in the control group[(48.83±3.29)s,(5.01±1.12)min],the differences were statistically significant(P<0.05).The visual analogue scale(VAS)pain scores at 6 and 12 h after operation in the observation group were(2.65±0.76),(2.02±0.65)points,which were lower than those in the control group[(3.44±0.80),(2.11±0.62)points],the differences were statistically significant(P<0.05).There was no significant difference between the observation group and the control group in progesterone,FSH and estradiol at 1 week after operation(P>0.05).There was no significant difference between the observation group and the control group in the occurrence of body movement,respiratory depression and nausea and vomiting during operation(P>0.05).The incidence of cough in the observation group was 0,which was significantly lower than that in the control group(23.53%),the difference was statistically significant(P<0.05).Conclusion Butorphanol preinjection combined with ramazolam has a good anesthetic effect in hysteroscopic surgery for endometrial polyps,which is helpful to stabilize hemodynamics,reduce postoperative pain,and reduce adverse reactions.