【摘要】 目的对于既往分娩史患者是否可减少无痛宫腔镜手术中丙泊酚用量尚不明确。文中旨在观察患者既往经阴道分娩史对无痛宫腔镜丙泊酚用量的影响。方法选取2018年11月至2019年5月安徽医科大学第一附属医院妇科门诊120例择期拟行无痛宫腔镜手术患者。根据有无分娩史分为对照组(无分娩史,n=60)和分娩史组(有分娩史,n=60)。比较2组患者麻醉前、扩宫时、术毕、术毕10 min和术毕30 min基本生命体征丙泊酚总用量、丙泊酚诱导量、丙泊酚追加例数和追加用量等指标,及术后第1、2、3天宫缩痛发生率等。结果分娩史组丙泊酚总用量较对照组明显减少[(133.3±25.4)mg vs (145.1±27.8)mg,P<0.05],丙泊酚追加率减少(46.7%vs 65%,P<0.05),苏醒时间明显缩短[(32.7±10.2)s vs (42.8±11.5)s,P<0.05],丙泊酚追加用量明显减少(P<0.05)。术毕及术毕10 min,分娩史组平均动脉压较对照组显著增高(P<0.05)。术后第2天,分娩史组宫缩痛I级发生率较对照组显著增高(46.7%vs 22.3%,P<0.05),II级发生率明显降低(48.3%vs 66.7%,P<0.05)。结论既往有分娩史的患者行无痛宫腔镜手术时,需要减少丙泊酚用量,可缩短苏醒时间。更多还原

【Abstract】 Objective To observe the effect of vaginal delivery history on the dosage of propofol and the quality of postoperative recovery in painless hysteroscopy patients.Methods120 patients from November 2018 to May 2019 who required painless hysteroscopy were enrolled in the First Affiliated Hospital of Anhui Medical University. According to their previous history,the patients were divided into two groups:the control group(no history of delivery,60 cases)and the observation group(had a history of delivery,60 cases). Basic vital signs(MAP,HR)of the two groups were compared at the following five time points:baseline,uterin edilation,immediately,10 min and 30 min after surgery. The dosage of sufentanil,the total and induced dosage of propofol,the additional cases and dosage of propofol,the time of surgery and recovery,the satisfaction of doctor and patients were recorded.ResultsCompared with the control group,the observation group showed significant decrease in the total dosage of propofol[(133.3±25.4)mg vs(145.1±27.8)mg],the additional cases[(28,46.7%)vs(39,65%)]and dosage of propofol[(1.0,2.0)mg vs(0.0,40.0)mg],and shorter recovery time[(32.7±10.2)s vs(42.8±11.5)s](all P<0.05). The satisfaction of doctor and patients were significantly higher in the observation group than in the control group. There was no significant difference in adverse events between the two groups(P>0.05).ConclusionIn painless outpatient hysteroscopy,in order to shorten the recovery time of patients,improve the quality of postoperative recovery,improve the efficiency and safety of painless hysteroscopic surgery,anesthesiologists should reduce the additional dosage of propofol for patients with previous vaginal delivery.更多还原