目的：比较依托咪酯与丙泊酚分别联合瑞芬太尼应用于宫腔镜手术的麻醉效果。方法：收治宫腔镜手术女性患者80例，随机分为依托咪酯-瑞芬太尼(ER)组和丙泊酚-瑞芬太尼(PR)组各40例。记录术前(T1)、术中(T2)和苏醒时(T3)的收缩压(SBP)、舒张压(DBP)、HR、SPO2及术中 BIS 值、诱导时间、手术时间、术后苏醒时间、定向力恢复时间，观察术中不良反应发生情况及术后并发症的发生率。结果：ER组术中收缩压(SBP)低于术前(P＜0.05)。PR组术中、术后的SBP、DBP及术中的HR、SPO2均低于术前(P＜0.05)。ER组诱导时间及低氧血症的发生率低于PR组(P＜0.05)，肌肉震颤的发生率高于PR组，苏醒时间及定向力恢复时间ER组明显缩短(P＜0.05)。两组术中的BIS值、手术时间、术后头晕、恶心呕吐等不良反应的发生率差异无统计学意义(P＞0.05)。结论：宫腔镜手术中，应用依托咪酯-瑞芬太尼麻醉引起的不良反应率明显低于丙泊酚-瑞芬太尼麻醉。%Objective:To compare the anesthetic effect of etomidate and propofol separately combined with remifentanil in hysteroscopic surgery.Methods:80 female patients with hysteroscopic surgery were selected.They were randomly divided into the etomidate-remifentanil(ER) group and the propofol-remifentanil(PR) group with 40 cases in each.The systolic blood pressure(SBP) and diastolic blood pressure(DBP),HR, SpO2 and intraoperative BIS value,induction time,operation time, postoperative recovery time,directional force recovery time were recorded before operation(T1),during operation(T2) and when waking up(T3).The intraoperative adverse reactions and postoperative complication incidence rate were observed.Results:The intraoperative systolic blood pressure(SBP) of ER group was lower than that before operation(P<0.05).The intraoperative and postoperative SBP、DBP and intraoperative HR,SPO2 of PR group were lower than those before operation(P<0.05).The induction time and hypoxia incidence rate of ER group were lower than those of PR group(P<0.05);the incidence rate of muscle tremor was higher than that of PR group;the recovery time and the directional force recovery time of ER group were significantly shorter(P<0.05).There was no significant difference in the incidence rate of BIS value,operation time,postoperative dizziness,nausea,vomiting and other adverse reactions between groups(P>0.05).Conclusion:In hysteroscopic surgery,the adverse reaction of application of etomidate-remifentanil anesthesia was significantly lower than that of propofol-remifentanil anesthesia.
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