环泊酚用于肥胖患者宫腔镜手术麻醉的安全性及有效性

Safety and efficacy of ciprofol in hysteroscopic surgery in obese patients

目的观察和评价环泊酚用于肥胖患者宫腔镜手术麻醉中的安全性及有效性.方法选取全麻下行宫腔镜手术的患者80例(ASA I~Ⅲ级,年龄24~58岁,体质指数28~32 kg/m2),随机分成环泊酚组和丙泊酚组,每组40例.两组患者先给予静脉注射地佐辛注射液2.5 mg,3 min后环泊酚组缓慢推注环泊酚0.5 mg/kg,丙泊酚组缓慢推注丙泊酚2.0 mg/kg,患者睫毛反射消失后开始手术.术中患者对手术刺激出现肢体扭动等反应时酌情追加药液.观察并记录患者平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)的变化;评定麻醉效果:记录诱导时间、苏醒时间、定向力恢复时间、术后疼痛评分;记录不良反应、苏醒质量以及离院评分情况.结果环泊酚组的术中低血压、呼吸抑制、低氧血症、需要托下颌(呼吸道梗阻)、手臂疼痛事件的发生率低于丙泊酚组,差异有统计学意义(P<0.05);环泊酚组的麻醉苏醒时间和定向力恢复时间低于丙泊酚组,差异有统计学意义(P<0.05);两组术中心动过缓、体动、呛咳、术后恶心呕吐事件的发生以及诱导时间比较,差异无统计学意义(P>0.05).结论与丙泊酚相比,环泊酚用于肥胖患者宫腔镜手术麻醉可有效降低术中不良反应事件的发生、加快术后复苏、减轻术后疼痛,其安全性与有效性更高.

Objective To observe the safety and efficacy of cyclopofol in obese patients undergoing hysteroscopic surgery.Methods A total of 80 patients undergoing general anesthesia for laparoscopic surgery were selected(ASAⅠ-Ⅲ,aged 24-58 years,body mass index 28-32 kg/m2)and randomly divided into propofol group and sevoflurane group,with 40 patients in each group.Both groups received intravenous injection of dexmedetomidine hydrochloride 2.5 mg,followed by slow injection of propofol 2.0 mg/kg in the sevoflurane group and propofol 0.5 mg/kg in the propofol group after 3 minutes.Surgery began when the patients had no eyelash reflex.Additional drugs were given as needed when the patient responded to surgical stimuli with limb movement,etc.Changes in mean arterial pressure(MAP),heart rate(HR),and oxygen saturation(SpO2)were observed and recorded.Anesthetic effect was evaluated by induction time,recovery time,orientation recovery time,postoperative pain score,adverse reactions,recovery quality,and discharge score.Results The incidence of intraoperative hypotension,respiratory depression,hypoxemia,need for jaw support(airway obstruction),and arm pain in the propofol group was lower than that in the sevoflurane group,with statistically significant differences(P<0.05);the anesthesia recovery time and orientation recovery time in the propofol group were lower than those in the sevoflurane group,with statistically significant differences(P<0.05);there were no statistically significant differences(P>0.05)in intraoperative bradycardia,body movement,coughing,postoperative nausea and vomiting,and induction time between the two groups.Conclusion Compared with sevoflurane,propofol for anesthesia in obese patients undergoing laparoscopic surgery can effectively reduce the incidence of adverse events during surgery,accelerate postoperative recovery,and relieve postoperative pain,with higher safety and effectiveness.