羟考酮与地佐辛用于诊断性刮宫术的效果比较

Comparison of oxycodone and dezocine for diagnostic curettage

目的本研究通过观察丙泊酚复合羟考酮和丙泊酚复合地佐辛用于诊断性刮宫术的麻醉效果和不良反应率的比较,探讨一种更安全高效的麻醉方式以满足诊断性刮宫术的麻醉需要,为临床麻醉医师合理选择麻醉方案提供参考。方法选取2020年9月至2022年12月于中国人民解放军联勤保障部队第九六七医院进行诊断性刮宫术的120例患者作为研究对象,年龄35~65周岁,美国麻醉医师协会(ASA)Ⅰ~Ⅱ级,体质量45~70 kg。随机将患者分为A,B 2组,每组60例。A组采用羟考酮(0.1 mg/kg)复合丙泊酚进行麻醉,B组采用地佐辛(0.1 mg/kg)复合丙泊酚进行麻醉。记录2组入室时(T1)、意识消失时(T2)、开始诊刮时(T3)、手术结束时(T4)的心率(HR),平均动脉压(MAP),脉搏氧饱和度(SPO_(2))。记录2组的不良反应率及术后10 min VAS疼痛评分。结果A组和B组在T1、T2、T3、T4各时间点的MAP、HR、SPO_(2)比较差异无统计学意义(P>0.05);2组在T2、T3、T4与T1相比MAP、HR均有下降,T2时下降最为明显,差异有统计学意义(P<0.05);2组在T2、T3与T1相比SPO_(2)均有下降,差异有统计学意义(P<0.05);2组的呼吸抑制率和体动反应率比较差异无统计学意义(P>0.05);A组在术后恶心呕吐率、术后10 min的VAS评分均低于B组,差异有统计学意义(P<0.05)。结论羟考酮复合丙泊酚和地佐辛复合丙泊酚用于诊断性刮宫术时均可满足基本麻醉要求,且2组患者生命体征平稳,但是羟考酮组的术后镇痛效果优于地佐辛组且恶心呕吐率更低,说明羟考酮复合丙泊酚麻醉效果可靠,安全性高,更适用于诊断性刮宫术。

Objective The aim of this study is to compare the anesthetic effect and adversereaction rate of propofol combined with oxycodone and propofol combined with dezocine in diagnostic curettage,to explore a safer and more efficient anesthesia method to meet the needs of diagnostic curettage,and to provide reference for clinical anesthesiologists to choose a reasonable anesthesia program.Methods A total of 120 patients who underwent diagnostic curettage in the 967 Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army from September 2020 to December 2022 were selected as the research objects,aged 35-65 years,ASA Ⅰ-Ⅱgrade,and weighing 45~70 kg.The patients were randomly divided into group A and group B,60 cases in each group.Group A was anesthetized with oxycodone(0.1 mg/kg)combined with propofol,and group B was anesthetized with dezocine(0.1 mg/kg)combined with propofol.Heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SPO_(2))were recorded at the time of entering the operation room(T1),loss of consciousness(T2),beginning of curettage(T3)and the end of operation(T4).The adverse reaction rate and VAs pain score at 1omin after operation were recorded.Results There was no significant difference in MAP,HR and SPO_(2) a between group A and group B at T1,T2,T3 and T4(P>0.05).The MAP and HR of the two groups at T2,T3 and T4 decreased compared with those at T1,and the decrease was most obvious at T2(P<0.05).SPO_(2) of T2 and T3 in both groups decreased compared with T1,and the difference was statistically significant(P<0.05).There was no significant difference in respiratory depression rate and body movement response rate between the two groups(P>0.05).The incidence of postoperative nausea and vomiting and VAs score 10 min after operation in group A were lower than those in group B,and the differences were statistically significant(P<0.05).Conclusion Oxycodone combined with propofol and dezocine combined with propofol can meet the basic anesthesia requirements for diagnostic curettage,and the vital signs of the two groups of patients are stable,but the postoperative analgesic effect of oxycodone group is better than that of dezocine group,and the nausea and vomiting rate is lower,indicating that oxycodone combined with propofol anesthesia is reliable.It is safe and more suitable for diagnostic curettage.