【摘要】 目的探讨瑞芬太尼与曲马多复合异丙酚用于宫腔镜电切术的麻醉效果。方法选择门诊ASAⅠ～Ⅱ级宫腔镜电切术患者60例,随机分为瑞芬太尼组(R组)、曲马多组(T组)和单用异丙酚组(P组),每组各20例,R组瑞芬太尼1.0μg·kg-1持续静注60秒,异丙酚2mg?kg-1诱导,T组曲马多2mg·kg-1+异丙酚2mg·kg-1诱导,P组单用异丙酚2mg·kg-1诱导,维持每次追加异丙酚0.5～1.0mg·kg-1,观察术中血流动力学的变化,注射痛和术后宫缩痛的发生情况,记录异丙酚用量、手术时间以及不良反应。结果三组麻醉后SBP和DBP有不同程度下降(P<0.01),R组HR诱导后5min、7min与诱导前比较明显下降(P<0.01),R组、T组注射痛明显低于P组(P<0.01),T组术后宫缩痛、呼吸抑制发生率明显低于R组、P组(P<0.01),R组、P组组间无差异(P>0.05)。R组、T组异丙酚用量明显少于P组(P<0.01)。术后患者无恶心、呕吐发生。结论瑞芬太尼与曲马多复合异丙酚用于宫腔镜电切术较单用异丙酚具有麻醉效果好,能减少异丙酚用量,减轻异丙酚的注射痛,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the clinical effects and the safety of remifentanil or tramadolwith propofol anesthesia for hysteroscopic surgery. Methods Sixty ASAⅠ～Ⅱ patients undergoinghysteroscopic surgery were randomly divided into three groups of 20 patients: group R,group T, groupP.In group R anesthesia was induced with remifentanil 1.0μg·kg-1 and propofol 2mg·kg-1,in group Tit was induced with tramadol 2mg·kg-1 and propofol 2mg·kg-1,whereas in group P it was induced withpropofol 2mg·kg-1,and was maintained with propofol 0.5～1.0mg·kg-1.The following were recorded andcompared in the three groups:⑴hemodynamic changes during anesthesia;⑵pains of intravenous injec-tion and postoperative pains of uterine contraction;⑶the total doses of propofol,⑷the side-effectsafter operation.Results During in induction SBP and DBP were significantly lower in the three groups(P<0.01).The incidence of pains of intravenous injection was significantly lower in group R and groupT than that in group P(P<0.01).Postoperative pains of uterine contraction and the incidence ofrespiratory suppression was significantly lower in group T than that in group R and group P(P<0.01).The total doses of propofol used were less in group R and group T than that in group P(P<0.01).Conclusion Remifentanil or tramadol with propofol anesthesia has better effect than big dosespropofol single when used for hysteroscopic surgery, and can decrease propofol doses and the painintensity of intravenous injection.更多还原