摘要
目的探讨在宫腔镜手术中应用艾司氯胺酮对患者疼痛程度、不良反应的影响。方法选取2020-01-10-2021-07-10南通大学附属南通市妇幼保健院收治的拟行宫腔镜手术患者123例作为研究对象,按照随机数字法分为A组(41例)、B组(41例)与C组(41例)。A组术中采用0.8mg/kg艾司氯胺酮+1.5mg/kg丙泊酚;B组术中采用0.5mg/kg艾司氯胺酮+1.5mg/kg丙泊酚;C组术中采用0.1μg/kg舒芬太尼+1.5mg/kg丙泊酚。采用SNK-q检验比较3组患者的术后术毕唤醒时间、手术时间及术后的不良反应,比较手术前后3组用视觉模拟评分法(VAS)宫缩疼痛情况,随访3个月,分析平均动脉压(MAP)、心率(HR)和呼吸频率(RR),比较3组不良反应。结果B组术毕唤醒时间、手术时间均低于A和C组,差异有统计学意义,均P<0.05;A组低于C组,差异有统计学意义,P<0.05。术后30min 3组VAS评分比较,差异有统计学意义(P<0.05),且A和B组VAS评分低于C组,差异有统计学意义,P<0.05。术后24h3组VAS评分低于术后30min,差异有统计学意义,P<0.05。3组术前不同时刻MAP、HR、RR比较差异均无统计学意义,F=10.854,P>0.05。A组T_(1)~T_(5)时刻MAP水平下降,B和C组T_(1)~T_(5)时刻MAP水平上升,且B组MAP水平高于A组,差异有统计学意义,F=12.874,P<0.05。A组T_(1)~T_(5)时刻HR水平下降,B和C组T_(1)~T_(2)时刻HR水平上升,差异有统计学意义(F=16.741,P<0.05),T_(2)~T_(5)时刻HR水平下降,B组HR水平在T_(1)~T_(5)时刻高于A组,差异有统计学意义,F=18.845,P<0.05。A组T_(1)~T_(5)时刻RR水平下降,B和C组T_(1)~T_(2)时刻RR水平上升,差异有统计学意义(F=14.578,P<0.05),T_(2)~T_(5)时刻HR水平下降,B组RR水平在T_(1)~T_(5)时刻高于A组,差异有统计学意义,F=17.452,P<0.05。3组术后的总不良反应发生率比较差异无统计学意义(F=0.879,P=0.349),但B组呼吸抑制率低于C组,差异有统计学意义,F=4.100,P=0.043。结论艾司氯胺酮应用于宫腔镜手术中,可缩短术毕唤醒时间、手
Objective To investigate the effect of esmolodione on pain and adverse reactions in hysteroscopic surgery.Methods Totally 123 patients who were admitted to Nantong Maternal and Child Health Hospital Affiliated to Nantong University from January 10,2020 to July 10,2021 were randomly divided into group A(41 cases),group B(41 cases)and group C(41 cases).Group A was treated with 0.8 mg/kg esmketamine+1.5mg/kg propofol,and group B was treated with 0.5 mg/kg esmketamine+1.5 mg/kg propofol;Group C was treated with 0.1μg/kg sufentanil+1.5 mg/kg propofol.Snk-q test was used to compare the postoperative wake-up time,operation time and postoperative adverse reactions of the three groups.The uterine contraction pain of the three groups before and after operation was compared by visual analogue scale(VAS).The patients were followed up for 3 months.Mean arterial pressure(MAP),heart rate(HR)and respiratory rate(RR)were analyzed,and the adverse reactions of the three groups were compared.Results The wake-up time and operation time after operation in group B were lower than those in groups A and C,and the difference was statistically significant(P<0.05);Group A was lower than group C(P<0.05).There was a statistically significant difference in VAS scores among the three groups 30 min after operation(P<0.05).The VAS score of group A and B was significantly lower than that of group C(P<0.05).The VAS score of 3 groups at 24 hours after operation was lower than that 30 minutes after operation,the difference was statistically significant(P<0.05).There was no significant difference in MAP,HR and RR between the three groups at different times before operation,(F=10.854,P>0.05).MAP level in group A decreased during T_(1)-T_(5),MAP level in group B and group C increased during T_(1)-T_(5),and MAP level in group B was higher than that in group A(F=12.874,P<0.05),HR level in group A decreased from T_(1)to T_(5),HR level in group B and group C increased from T_(1)to T_(2)(F=16.741,P<0.05),HR level in group B decreased from T_(2)to T_(5),and
作者
刘琳琳
朱翔
LIU Lin-lin;ZHU Xiang(Department of Anesthesiology,Nantong Maternal and Child Health Hospital,Nantong University,Nantong 226000,China)
出处
《社区医学杂志》
CAS
2022年第22期1280-1284,共5页
Journal Of Community Medicine
