阿芬太尼联合丙泊酚用于宫腔镜检查术的麻醉效果分析

Analysis of the Anesthetic Effect of Alfentanil Combined with Propofol for Hysteroscopy Examination Surgery

目的研究宫腔镜检查手术中采用阿芬太尼联合丙泊酚的麻醉效果及安全性,探讨阿芬太尼联合丙泊酚用于宫腔镜检查术时的更佳剂量。方法选取2022年9月—2023年9月在中山大学附属第一医院惠亚医院行宫腔镜检查手术的患者150例为研究对象,通过随机数表法分为A1、A2和F组,每组50例,分别静注阿芬太尼5µg/kg(A1组)、阿芬太尼10µg/kg(A2组)和芬太尼1µg/kg(F组),观察并记录丙泊酚的总用量、起效时间、意识恢复时间及手术时间、术中体动情况、呼吸抑制发生率、术后疼痛情况及恶心呕吐发生情况。结果注药前(T1),3组患者平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)及经皮动脉血氧饱和度(percutaneous arterial oxygen saturation,SpO_(2))比较,差异无统计学意义(P>0.05);T2~T6时,A2组MAP高于其余两组,差异有统计学意义(P<0.05);3组患者手术时间比较,差异无统计学意义(P>0.05);与A1组的(247.2±22.86)mg、F组的(258.6±21.4)mg比较,A2组丙泊酚总用量为(203.1±20.2)mg明显减少,差异有统计学意义(P<0.05)。结论阿芬太尼联合丙泊酚用于宫腔镜检查术安全有效,10µg/kg阿芬太尼复合丙泊酚用于宫腔镜检查术镇痛效果佳,起效时间及苏醒时间短,丙泊酚用量少,术后不良反应发生率低。

Objective To study the anesthetic effect and safety of using alfentanil combined with propofol in hysteros‐copy examination surgery,and to explore the better dosage of alfentanil combined with propofol when used in hysteros‐copy examination surgery.Methods 150 patients who underwent hysteroscopy examination surgery in the Huiya Hos‐pital of the First Affiliated Hospital of Sun Yat-sen University from September 2022 to September 2023 were selected as the research object,and were randomly divided into group A1,A2 and F,by randomized numerical table method,50 cases in each group,respectively,static injection of alfentanil 5µg/kg(group A1),alfentanil 10µg/kg(group A2)and fentanyl 1µg/kg(group F).The total dosage of propofol,onset time,recovery time of consciousness and operation time,intraoperative body movement,incidence of respiratory depression,postoperative pain and incidence of nausea and vomiting were observed and recorded.Results There were no statistically significant difference in mean blood pressure(MAP),heart rate(HR),and percutaneous arterial oxygen saturation(SpO_(2))among the three groups of pa‐tients before drug injection(T1)(P>0.05).The change in MAP of group A2 was higher than that of the remaining two groups from T2 to T6,and the difference was statistically significant(P<0.05).There was no statistically significant dif‐ference in operation time among the three groups(P>0.05).Compared with group A1(247.2±22.86)mg and group F(258.6±21.4)mg,the total propofol dosage in group A2(203.1±20.2)mg was significantly reduced,and the difference was statistically significant(P<0.05).Conclusion Alfentanil combined with propofol for hysteroscopy examination sur‐gery is safe and effective,10µg/kg alfentanil compounded with propofol for hysteroscopy examination surgery has a good analgesic effect,the onset of action time and wake-up time is short,the dosage of propofol is small,and the inci‐dence of postoperative adverse reactions is low.