OBJECTIVE:To investigate effects of different doses of nalbuphine combined with propofol on anesthesia and anal-gesic effect of patients underwent hysteroscopic surgery. METHODS:A total of 120 inpatients undergoing painless hysteroscopic surgery were selected as research objects during Feb.-Nov. 2016. They were divided into group P,N1,N2,N3 according to ran-dom number table,with 30 cases in each group. Routine preoperative preparation was conducted in 4 groups. Group N1,N2,N3 were given Nalbuphine hydrochloride injection 0.05,0.10,0.15 mg/kg slowly,iv,within 1-2 min. After 3 min of injection,4 groups were given 2％ Lidocaine hydrochloride injection 2 mL,iv+ Propofol injection 1 mg/kg,iv(40 mg/10 s),and then injected with Propofol injection(10 mg/10 s)slowly until the patient's eyelash reflex disappeared and no response was aroused. During sur-gery,Propofol injection was infused with micro pump at 6 mg/(kg·h)to maintain anesthesia until the end of operation. The levels of hemodynamic parameters (SBP,DBP,HR) and SpO2 of 4 groups were observed after admission to operating room (T0),be-fore propofol infusion(T1),immediately after propofol infusion(T2),during uterine cervical distension(T3),at the end of surgery (T4) and during anesthesia recovery (T5),respectively. The induction dose,maintenance dose,total dose,total dosing time and unit time dose of propofol,anesthesia recovery time and NRS scores after anesthesia recovery of patients were also observed in 4 groups. The occurrence of ADR was recorded during operation and anesthesia recovery. RESULTS:There was no statistical signifi-cance in maintenance dose and total dosing time of propofol,the incidence of body motion reaction,hypotension,sinus bradycar-dia,nausea and vomiting among 4 groups (P>0.05). At T0,there was no statistical significance in hemodynamic parameters or SpO2 among 4 groups(P>0.05). Compared to T0,SBP of 4 groups were decreased significantly at T2,that of group N1 was de-creased significantly at T3-T4,and that of group N2 was decreased significantly at T3,with statistical significance(P0.05).T0时,4组患者血流动力学参数及SpO2比较,差异均无统计学差异(P>0.05).与T0时比较,4组患者SBP在T2时显著降低,N1组在T3、T4时显著降低,N2组在T3时显著降低,差异均有统计学意义(P<0.05);4组患者DBP在T2时显著降低,N1组在T3～T5时显著降低,N2组在T3时显著降低,差异均有统计学意义(P<0.05);P组患者在T3时HR显著降低,N3组在T5时显著降低,差异均有统计学意义(P<0.05);4组患者SpO2在T2时显著降低,N3组在T3时显著降低,差异均有统计学意义(P<0.05);N3组患者T1时SpO2显著低于P组,在T2时显著低于其余各组,在T3时显著低于P组和N1组,差异均有统计学意义(P<0.05).与P组比较,N2、N3组患者丙泊酚诱导剂量、总剂量、单位时间剂量及NRS评分均显著降低;N1、N2和N3组麻醉苏醒时间均显著缩短,差异均有统计学意义(P<0.05).与N1组比较,N2、N3组丙泊酚诱导剂量、总剂量、单位时间剂量和NRS评分均显著降低,麻醉苏醒时间显著缩短,差异均有统计学意义(P<0.05).与N2组比较,N3组丙泊酚诱导剂量、总剂量均显著降低,差异均有统计学意义(P<0.05).与P组比较,N3组患者头晕发生率显著增加;与P、N1和N2组比较,N3组患者低氧血症发生率显著增加,差异均有统计学意义(P<0.05).结论:0.10 mg/kg的纳布啡联合丙泊酚用于宫腔镜手术既能达到良好的麻醉和镇痛效果,又具有较高的安全性.
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