CAJ | 학술논문

目的观察瑞芬太尼复合异丙酚用于宫腔镜手术的临床效果和安全性.方法门诊宫腔镜术患者100例,ABA Ⅰ～Ⅱ级,随机分成两组,瑞芬太尼组(R组):瑞芬太尼0.75μg/kg+异丙酚2mg/kg;芬太尼组(F组):芬太尼1μg/kg+异丙酚2mg/kg.术中间断推注异丙酚维持麻醉.于术毕前2min停药,记录意识消失时间、术后苏醒时间、苏醒期不良反应及异丙酚用药量;呼吸和血流动力学变化;患者术中VAS评分和停药后改良OAA/S镇静评分.结果 R组意识消失时间和苏醒时间较F组明显缩短,R组与F组相比异丙酚用药减少约30%(P<0.05);F组与R组比较平均动脉压(MAP)较基础值明显降低,R和F组呼吸暂停发生率分别为4%和24%(P<0.05);两组患者停药后3,4,5min改良OAA/S评分R组明显高于F组(P<0.05);但术中VAS评分和苏醒期不良反应两组间差异没有统计学意义(P>0.05).结论瑞芬太尼复合异丙酚在无痛宫腔镜术中应用,具有麻醉起效快、苏醒快和术中血流动力学稳定等优点,更适于门诊使用.
목적 관찰서분태니복합이병분용우궁강경수술적림상효과화안전성.방법 문진궁강경술환자100례,ABA Ⅰ～Ⅱ급,수궤분성량조,서분태니조(R조):서분태니0.75μg/kg+이병분2mg/kg;분태니조(F조):분태니1μg/kg+이병분2mg/kg.술중간단추주이병분유지마취.우술필전2min정약,기록의식소실시간、술후소성시간、소성기불량반응급이병분용약량;호흡화혈류동역학변화;환자술중VAS평분화정약후개량OAA/S진정평분.결과 R조의식소실시간화소성시간교F조명현축단,R조여F조상비이병분용약감소약30%(P<0.05);F조여R조비교평균동맥압(MAP)교기출치명현강저,R화F조호흡잠정발생솔분별위4%화24%(P<0.05);량조환자정약후3,4,5min개량OAA/S평분R조명현고우F조(P<0.05);단술중VAS평분화소성기불량반응량조간차이몰유통계학의의(P>0.05).결론 서분태니복합이병분재무통궁강경술중응용,구유마취기효쾌、소성쾌화술중혈류동역학은정등우점,경괄우문진사용.
Objective To investigate the clinical effects and safety of remifentanil and propofol during operation of hyst-eroscopy. Methods 100 ASA Ⅰ～Ⅱ patients undergoing outpatient hysteroscopy were randomly allocated into two groups. In the rernifentanil group(R group) anesthesia was induced with remifentanil 0.75μg/kg and propofol 2mg/kg, whereas in the fent-anyl group (F group) was fentanyl 1.0μg/kg and propofol 2mg/kg, and was maintained with propofol when needed. The follow-scale(VAS) and observers' assessment of alertness/sedation(OAA/S). Results The time of unconsciousness and recovery time from anesthesia at group R was significantly shorter compared with group F; The total doses of propofol used were less at group R than F group (P<0.05). The MAP at group F was depressed significantly; The incidence of apnea at group R and F were 4 % and 24 % (P<0.05). There was significant difference in the OAA/S between the groups(P<0.05). However, There was no sig-nificant difference between groups regarding VAS of pain and the side effects during recovery (P>0.05). Conclusion Remifen-tanil and propofol anesthesia appears to be superior for day-case hysteroscopy than fentanyl and propofol, with regards to the time of unconsciousness and recovery time from anesthesia and stably hemodynamics.