阿芬太尼复合瑞马唑仑对宫腔镜无痛诊疗患者血流动力学及苏醒质量的影响

Effects of fentanyl combined with remazolam for anesthesia during painless hysteroscopy diagnosis and treatment of patients on their hemodynamics and recovery quality

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摘要目的:探讨阿芬太尼复合瑞马唑仑对宫腔镜无痛诊疗患者血流动力学及苏醒质量的影响。方法:将2022年11月-2023年10月本院收治的60例宫腔镜无痛诊疗患者随机分成两组各30例,分别予以阿芬太尼复合丙泊酚麻醉(丙泊酚组)、阿芬太尼复合瑞马唑仑麻醉(瑞马唑仑组),其余麻醉方法相同。观察两组血流动力学(平均动脉压、心率)、苏醒质量(呼吸恢复、定向力恢复以及睁眼的时间)、疼痛程度(VAS评分)、氧化应激反应丙二醛(MDA)和超氧化物歧化酶(SOD)、不良反应(低血压、呼吸抑制、低氧血症、术中体动)。结果:瑞马唑仑组不同手术麻醉时点平均动脉压、心率均高于丙泊酚组,呼吸恢复(4.99±0.87 min)、定向力恢复(12.36±1.67 min)以及睁眼的时间(12.00±1.13 min)均短于丙泊酚组(7.87±1.01 min、15.25±2.16 min、15.74±1.58 min),术后1、3h的VAS评分(3.01±0.37分、3.32±0.65分)均低于丙泊酚组(3.37±0.56分、4.05±0.81分),术后MDA(18.73±2.12 mmol/L)低于丙泊酚组(24.82±2.55 mmol/L),SOD(320.85±29.61 U/ml)高于丙泊酚组(275.37±27.97 U/ml),不良反应总发生率(6.7%)低于丙泊酚组(26.7%)(均P<0.05)。结论:阿芬太尼复合瑞马唑仑在宫腔镜无痛诊疗麻醉应用效果较好,可稳定患者的血流动力学,提高苏醒质量,减轻术后疼痛及氧化应激反应,且能减少不良反应,在一定程度提高了麻醉的有效性与安全性。 Objective:To explore the effects of fentanyl combined with remimazolam for anesthesia during painless hysteroscopy diagnosis and treatment of patients on their hemodynamics and recovery quality.Methods:60 patients who wanted painless hysteroscopic diagnosis and treatment were randomly divided into two groups from November 2022 to October 2023.30 patients in group A received anesthesia with fentanyl combined with propofol,while 30 patients in group B received anesthesia with fentanyl combined with remimazolam.The rest of the anesthesia methods of the patients in the two groups were the same.The values of hemodynamics(mean arterial pressure,heart rate),the awakening quality(respiratory recovery,directional force recovery,and eye-opening time),the pain degree evaluated by VAS score,the levels of oxidative stress response,such as malondialdehyde(MDA)and superoxide dismutase(SOD),and the rates of adverse reactions(hypotension,respiratory depression,hypoxemia and intraoperative physical activity)of the patients in the two groups were observed.Results:The values of mean arterial pressure and heart rate of the patients in group B at different time points of anesthesia were significantly higher than those of the patients in group A.The time of breathing recovery(4.99±0.87 min),orientation recovery(12.36±1.67 min)and eye opening(12.00±1.13min)of the patients in group B were significantly shorter than those(7.87±1.01min,15.25±2.16min and 15.74±1.58min)of the patients in group A.The VAS score of the patients in group B at 1h(3.01±0.37points)and at 3h after operation(3.32±0.65points)were significantly lower than those(3.37±0.56points and 4.05±0.81points)of the patients in group A.The MDA level(18.73±2.12mmol/L)of the patients in group B was significantly lower than that(24.82±2.55mmol/L)of the patients in group A.The SOD level(320.85±29.61U/ml)of the patients in group B was significantly higher than that(275.37±27.97U/ml)of the patients in group A.The total incidence of adverse reactions(6.7%)of the patients in

作者林大艳尹泓刘波涛姜敏 LIN Dayan;YIN Hong;LIU Botao;JIANG Min(Huili People's Hospital,Huili,Sichuan Province,615100;The Fifth People's Hospital of Chengdu,Sichuan Province;Affiliated Hospital of Chengdu University,Chengdu,Sichuan Province)

机构地区四川省会理市人民医院四川省成都市第五人民医院成都大学附属医院

出处《中国计划生育学杂志》 2024年第3期522-526,共5页 Chinese Journal of Family Planning

基金成都市医学科研课题立项项目(2020082)。

关键词宫腔镜无痛诊疗阿芬太尼瑞马唑仑血流动力学苏醒质量疼痛程度氧化应激反应不良反应 Painless hysteroscopy diagnosis and treatment Alfentanil Remazolam Hemodynamics Awakening quality Pain degree Oxidative stress response Adverse reaction