【摘要】 目的:探究在进行宫腔镜电切手术时，麻醉方案采用瑞马唑仑联合阿芬太尼、丙泊酚联合阿芬太尼两种全凭静脉麻醉方案的应用效果。方法:研究时间为2023年1月至2023年6月，纳入研究对象为107例宫腔镜电切手术患者，根据随机数字表法分为对照组、观察组。对照组53例采用丙泊酚联合阿芬太尼全凭静脉麻醉，观察组54例采用瑞马唑仑联合阿芬太尼全凭静脉麻醉。比较两组患者的疼痛情况（使用VAS评分评估）、镇静情况（采用Ramsay镇静评分评估）、生命体征情况、改良警觉/镇静评分，记录不良反应情况。结果:与对照组相比，观察组在术后2h及术后12h的VAS评分降低（P<0.05）,术后2h时的Ramsay镇静评分升高（P<0.05）。两组在手术前的HR、SBP、DBP、SPO₂差异无统计学意义（P>0.05）,与对照组患者相比较，观察组患者手术开始后5min及术后2h的HR、SBP、DBP、SPO₂水平均升高（P<0.05）。两组的VAS评分、Ramsay镇静评分、生命体征指标均具有显著的组间效应、时间效应及交互效应（P<0.05）。观察组患者手术结束后1min、3min、5min时MOAA/S评分比对照组高（P<0.05）。组间不良反应发生率差异无统计学意义（P>0.05）。结论:瑞马唑仑联合阿芬太尼应用于宫腔镜电切手术麻醉在术后早期具有更好的疼痛控制和镇静效果，且患者恢复清醒状态更快，生命体征水平维持更稳定。更多还原

【Abstract】 Objective: To investigate the application efficacy of two total intravenous anesthesia regimens, remifentanil combined with alfentanil versus propofol combined with alfentanil, during hysteroscopic electrosurgical procedures.Methods: From January 2023 to June 2023, a total of 107 patients undergoing hysteroscopic electrosurgical procedures were included and randomly allocated using a random number table into a control group（n=53） receiving propofol combined with alfentanil anesthesia and an observation group（n=54） receiving remifentanil combined with alfentanil anesthesia. Pain intensity（evaluated using VAS scores）, sedation levels（assessed by Ramsay Sedation Scale）, vital signs, Modified Aldrete Score（MAS）, and adverse reactions were compared between the two groups.Results: Compared with the control group, the observation group showed significantly lower VAS scores at 2 hours and 12 hours postoperatively（P<0.05） and higher Ramsay Sedation Scale scores at 2 hours postoperatively（P<0.05）. There were no significant differences in preoperative heart rate（HR）, systolic blood pressure（SBP）, diastolic blood pressure（DBP）, and oxygen saturation（SPO₂） between the two groups（P>0.05）. However, HR, SBP, DBP, and SPO₂ levels were significantly higher in the observation group than in the control group at 5 minutes after the start of surgery and at 2 hours postoperatively（P<0.05）. Significant group effects, time effects, and interaction effects were observed for VAS scores, Ramsay Sedation Scale scores, and vital signs（P<0.05）. The observation group had higher Modified Observer’s Assessment of Alertness/Sedation（MOAA/S） scores at 1, 3, and 5 minutes after surgery compared to the control group（P<0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion: Remifentanil combined with alfentanil provides better pain control and sedation during early postoperative period in patients undergoing hysteroscopic electrosurgical procedures compared to propofol combined with alfentanil. Patients recover faster to a clear consciousness state, and their vital signs are more stable during anesthesia.更多还原