盐酸氢吗啡酮复合丙泊酚在无痛宫腔镜检查中的应用

摘要

目的:观察盐酸氢吗啡酮复合丙泊酚用于无痛宫腔镜检查的镇痛效果及安全性.方法:选取60例全麻下行宫腔镜检查术患者,ASAⅠ～Ⅱ级,随机分为氢吗啡酮复合丙泊酚组(H组)和芬太尼复合丙泊酚组(F组),每组30例.H组静脉注射氢吗啡酮0.5 mg复合丙泊酚麻醉,F组静脉注射芬太尼0.05 mg复合丙泊酚麻醉.记录两组患者麻醉诱导前(T0)、诱导后(T1)、扩宫颈时(T2)、宫内操作时(T3)、苏醒时(T4)各时间点的平均动脉压(M AP)、心率(HR)、血氧饱和度(SpO2),以及宫腔镜检查时间、苏醒时间、丙泊酚用量、术后30 min视觉模拟评分法(VAS)评分和副作用的发生情况.结果:与T0比较,T1、T2、T3时间点两组 HR明显减慢,MAP、SpO2明显降低(P<0.05);术后30 min V AS评分 H组为(1.7 ± 0.8)分,低于F组的(3.0 ± 0.7)分(P<0.05).结论:氢吗啡酮复合丙泊酚用于宫腔镜检查安全有效,术后镇痛效果好.%Objective:To investigate the effect and safety of hydromorphone combined with propofol for pa-tients underwent hysteroscopy.Methods:Totally 60 ASA Ⅰ～Ⅱ patients scheduled for hysteroscopy under intrave-nous anesthesia were randomly divided into group H and group F with 30 patients in each group,according to random number tables.Anesthesia was induced with hydromorphone 0.5 mg and propofol for patients in group H,while pa-tients in group Fwere induced with fentanyl 0.05mg and propofol.The MAP,HR and SpO2were recorded before ex-amination(T0),after induction of anesthesia(T1),expanding cervix(T2),intrauterine operation(T3),and wake time(T4).Recovery time,operation time,propofol consumption,post-operative 30min VAS scores and side effects were recorded accordingly.Results:There were statistical significance between two groups in HR,MBP and SpO2at T1,T2and T3.They were lower than those in T0(P<0.05).The post-operative 30min VAS scores(1.7 ± 0.8)in group H was lower than that in group F(3.0 ± 0.7)(P<0.05).Conclusion:Hydromorphone combined with propofol is safe and effective for hysteroscopy,and better postoperative analgesia effect.