丙泊酚复合瑞芬太尼靶控输注清醒镇静镇痛在宫腔镜检的应用

Application of propofol combined with remifentanil target-controlled infusion for conscious sedation and analgesia in hysteroscopy

目的探讨丙泊酚复合瑞芬太尼靶控输注清醒镇静镇痛在宫腔镜检中的应用效果。方法选取2017年9月-2018年6月该院妇科门诊行宫腔镜检查术患者50例,采用随机数字表法分为观察组(n=25)和对照组(n=25)。两组患者均给予丙泊酚复合瑞芬太尼麻醉镇痛,对照组患者采用手动输注,观察组患者采用靶控输注。分析比较两组患者的镇静镇痛效果。结果 (1)麻醉后2 min和扩张宫颈时,观察组患者的平均动脉压和心率高于对照组(P<0.05)。(2)观察组患者清醒即刻、术后15 min和术后30 min时的视觉模拟评分法(VAS)评分均小于对照组,Ramsay评分大于对照组(P<0.05)。(3)观察组患者的麻醉起效时间和离室时间短于对照组,苏醒时间、定向力恢复时间长于对照组,差异有统计学意义(P<0.05);两组患者的术中记忆比例比较差异无统计学意义(P>0.05)。结论瑞芬太尼复合丙泊酚靶控输注可有效维持宫腔镜检查术患者血流动力学的稳定,维持良好的镇静镇痛效果,实现宫腔镜检患者的快速平稳苏醒。

【Objective】To investigate the effect of propofol combined with remifentanil target-controlled infusion on conscious sedation and analgesia in hysteroscopy.【Methods】Fifty patients undergoing hysteroscopy at the gynaecological clinic in our hospital from September 2017 to June 2018 were enrolled.The patients were divided into observation group(n=25)and control group(n=25)by random number table.Both groups were given propofol combined with remifentanil for analgesia.The control group received manual infusion and the observation group received target-controlled infusion.The sedative analgesic effect of the two groups of patients was analyzed and compared.【Results】Two minutes after anesthesia and dilatation of the cervix,mean arterial pressure and heart rate of patients in the observation group were higher than those in the control group(P<0.05).The VAS scores of the observation group were significantly shorter than that of the control group,and the Ramsay score was greater than that of the control group(P<0.05).The anesthesia onset time,recovery time,orientation recovery and detachment time were shorter in the observation group than in the control group(P<0.05).There was no significant difference in intraoperative memory between the two groups(P>0.05).【Conclusion】Remifentanil combined with propofol target-controlled infusion can effectively maintain the hemodynamic stability of patients undergoing hysteroscopy,maintain a good sedative and analgesic effect,and achieve rapid and stable recovery of patients undergoing hysteroscopy.