右美托咪定和舒芬太尼联合小剂量丙泊酚用于宫腔镜手术麻醉的临床效果

Clinical Effects of Dexmedetomidine and Sufentanil Combined with Low dose Propofol for Hysteroscopic Surgery Anesthesia

目的探讨右美托咪定和舒芬太尼联合小剂量丙泊酚用于宫腔镜手术麻醉的临床效果。方法随机选取2022年6月—2023年8月上杭县医院麻醉科行宫腔镜手术的160例患者为研究对象,根据不同麻醉方案分为两组,各80例。对照组麻醉诱导应用舒芬太尼和丙泊酚,术中静脉维持应用丙泊酚;研究组麻醉诱导应用舒芬太尼、右美托咪定和小剂量丙泊酚,静脉维持应用小剂量丙泊酚和右美托咪定。对比两组围术期不良反应发生率,不同时间的平均动脉压和心率变化情况,苏醒时间,麻醉前和苏醒后的疼痛、镇静评分情况。结果研究组不良反应总发生率为6.25%(5/80)低于对照组的23.75%(19/80),差异有统计学意义(χ^(2)=9.608,P<0.05)。研究组麻醉诱导后、扩宫时的平均动脉压均高于对照组,差异有统计学意义(P均<0.05)。两组不同时间点的心率对比,差异无统计学意义(P>0.05)。研究组苏醒时间短于对照组,苏醒后疼痛评分、Richmond躁动-镇静评分均低于对照组,差异有统计学意义(P均<0.05)。结论宫腔镜手术麻醉中,使用右美托咪定、舒芬太尼和小剂量丙泊酚的联合应用可以有效降低发生不良反应率,可以获得良好的镇静镇痛效果。

Objective To investigate the clinical effect of dexmedetomidine,sufentanil combined with low-dose propo⁃fol in hysteroscopic surgery.Methods A total of 160 patients who underwent hysteroscopic surgery in the Department of Anesthesiology in Shanghang County Hospital from June 2022 to August 2023 were randomly selected as the re⁃search objects.According to different anesthesia schemes,they were divided into two groups,80 cases in each group.In the control group,sufentanil and propofol were used for anesthesia induction,and propofol was used for intravenous maintenance during operation.In the study group,sufentanil,dexmedetomidine and low-dose propofol were used for anesthesia induction,and low-dose propofol and dexmedetomidine were used for intravenous maintenance.The inci⁃dence of perioperative adverse reactions,mean arterial pressure and heart rate changes at different times,recovery time,pain and sedation scores before and after anesthesia were compared between the two groups.Results The total in⁃cidence of adverse reactions in the study group was 6.25%(5/80)lower than that in the control group 23.75%(19/80),and the difference was statistically significant(χ^(2)=9.608,P<0.05).The mean arterial pressure after anesthesia induc⁃tion and during dilatation in the study group were higher than those in the control group,and the differences were sta⁃tistically significant(both P<0.05).There was no significant difference in heart rate between the two groups at differ⁃ent time points(P>0.05).The recovery time of the study group was shorter than that of the control group,the pain score and Richmond Agitation-sedation Scale score after recovery were lower than those of the control group,and the differences were statistically significant(all P<0.05).Conclusion In hysteroscopic surgery anesthesia,the combination of dexmedetomidine,sufentanil and low-dose propofol can effectively reduce the probability of adverse reactions,ob⁃tain good sedative and analgesic effects.