布托啡诺预注射联合瑞马唑仑...疗子宫内膜息肉中的应用研究_余波.pdf

4结论综上所述，艾司氯胺酮辅助罗哌卡因对在臂丛神经阻滞下老年肩关节镜手术患者的阻滞中，能够延长镇痛时间，且对患者的膈肌功能、血清 PPA、IGF 1 水平影响较低。参考文献 1鲍丽娜，吴振宇，杨晓春，等 右美托咪定复合罗哌卡因对肩关节镜手术中臂丛神经联合肩胛上神经阻滞的影响J 广东医学，2020，41(20):2102 2105 2何秀玲，孙苗，石琳琳，等 胆酸对代谢性炎症模型大鼠炎性因子及 PPA 和 LX 表达与分布的影响J 中国兽医学报，2022，42(6):1241 1248 3吴冠瑾，徐军，黑丹丹，等 卒中后认知功能障碍患者外周血 mi96 血清 IGF 1 的相关性及诊断价值J 中风与神经疾病杂志，2021，38(10):1083 1085 4李麟，殷国江，祝雨思，等 后路与前外侧路连续肌间沟臂丛神经阻滞对肩关节镜术后镇痛效果比较J 医学研究杂志，2021，50(6):145 149 5于丽丽，周琦，李伟，等 型胸神经阻滞联合艾司氯胺酮对全麻乳腺癌手术患者焦虑抑郁情绪的影响J 中华麻醉学杂志，2022，42(7):845 849 6吕晶，吴茜，陈向东，等 地塞米松复合右美托咪定对罗哌卡因臂丛神经阻滞效果和血浆皮质醇的影响J 临床麻醉学杂志，2020，36(9):842 846 7刘代云，孙凯，张宇帆，等 超声引导下星状神经节阻滞对全麻沙滩椅位肩关节镜手术患者术中 rSO2的影响 J 中华麻醉学杂志，2020，40(10):1221 1223 8任晓燕，姜艳华，郭丽丽，等 超声引导下股神经 腘窝坐骨神经阻滞麻醉应用于膝关节镜手术的临床效果J 实用临床医药杂志，2020，24(13):84 86 9赵霞，周海滨，郑少强，等 低浓度局部麻醉药物对肩关节镜患者肌间沟臂丛神经阻滞后膈肌功能的影响J 重庆医学，2022，51(9):1549 1553 10 于天雷，苏丽 连续后路肌间沟臂丛神经阻滞和经静脉患者自控镇痛在肩关节镜手术患者中的应用及对预后的影响 J 中国内镜杂志，2022，28(8):1 7 11 郭玲玲，何文胜，陈亮，等 艾司氯胺酮对无痛纤维支气管镜检查患者术后早期恢复质量的影响J 实用临床医药杂志，2022，26(6):90 94 12 杜海伟，李娟，涂涛 艾司氯胺酮对下肢静脉曲张手术患者术中生命体征及苏醒质量的影响J 成都医学院学报，2022，17(4):448 451 13 胡平，刘景诗，廖孝芸，等 艾司氯胺酮对全麻俯卧位腰椎手术患者心指数的影响J 中国医师杂志，2022，24(4):556 559，565 14 唐立飞，王婕，刘尧，等 艾司氯胺酮对虚弱患者全髋关节置换术后镇痛及炎症因子的影响J 国际麻醉学与复苏杂志，2022，43(6):590 595 15 孙艳斌，王文玺，安海燕，等 艾司氯胺酮对冠状动脉旁路移植手术患者血流动力学及术后谵妄发生率的影响J 河北医学，2022，28(4):684 689(收稿日期:2022 11 24)DOI:10 3969/j issn 1671 4695 2023 07 028文章编号:1671 4695(2023)07 0777 05布托啡诺预注射联合瑞马唑仑在宫腔镜手术治疗子宫内膜息肉中的应用研究余波1余雯雯2徐敏1(1 仙桃市第一人民医院麻醉科湖北仙桃433000;2 湖北医药学院湖北十堰442000)基金项目:湖北省自然科学基金(编号:2020CFB797)【摘要】目的探讨布托啡诺预注射联合瑞马唑仑在宫腔镜手术治疗子宫内膜息肉中的应用价值。方法前瞻性选取 2022 年 1 月至 10 月在仙桃市第一人民医院拟行宫腔镜下子宫内膜息肉摘除术患者 102 例，采用信封法将患者随机分为观察组(n=51)和对照组(n=51)，两组均行宫腔镜下子宫内膜息肉摘除术，观察组给予布托啡诺预注射联合瑞马唑仑，对照组给予瑞马唑仑。观察比较两组血流动力学指标、麻醉起效时间、术后苏醒时间、疼痛评分，血清孕酮、促卵泡激素(FSH)及雌二醇水平，以及术中不良反应情况。结果观察组麻醉后 5 min(T1)、扩宫即刻(T2)和术毕(T3)时平均动脉压(MAP)、心率明显高于对照组，差异均有统计学意义(P 0 05)。观察组麻醉起效时间和术后苏醒时间为(40 50 3 11)s、(3 50 1 02)min，明显低于对照组(48 83 3 29)s、(5 01 1 12)min，差异均有统计学意义(P 0 05)。观察组术后 6、12 h 时视觉模拟法(VAS)疼痛评分为(2 65 0 76)、(2 02 0 65)分，低于对照组(3 44 0 80)、(2 11 0 62)分，差异均有统计学意义(P 0 05)。观察组和对照组术后 1 周孕酮、FSH 和雌二醇比较，差异均无统计学意义(P 0 05)。观察组和对照组术中体动、呼吸抑制及恶心呕吐发生率比较，差异无统计学意义(P 0 05);观察组呛咳发生率为 0，明显低于对照组(23 53%)，差异有统计学意义(P 0 05)。结论布托啡诺预注射联合瑞马唑仑在宫腔镜手术治疗子宫内膜息肉中有较好的麻醉效果，优于单用瑞马唑仑，可减轻患者术后疼痛，并减少不良反应发生。【关键词】布托啡诺瑞马唑仑宫腔镜子宫内膜息肉应用价值777临床和实验医学杂志2023 年 4 月第 22 卷第 7 期Application of butorphanol preinjection combined with remazolam in hysteroscopic surgery for endometrial polyps YU Bo1，YU Wen wen2，XU Min1 1 Department of Anesthesiology，Xiantao First Peoples Hospital，Xiantao Hubei 433000，China;2 Hubei University of Medicine，Shiyan Hubei 442000，China【Abstract】ObjectiveTo investigate the application value of butorphanol pre injection combined with ramazolam in hysteroscopic surgeryfor endometrial polyps MethodsFrom January to October 2022，102 patients who were scheduled to undergo hysteroscopic endometrial polypec-tomy in Xiantao First Peoples Hospital were prospectively selected，the patients were randomly divided into the observation group(n=51)andthe control group(n=51)by envelope method，both groups underwent hysteroscopic endometrial polypectomy，the observation group was givenbutorphanol preinjection combined with remazolam anesthesia，and the control group was given remazolam anesthesia The hemodynamic parame-ters，onset time of anesthesia，postoperative recovery time，pain score，serum progesterone，follicle stimulating hormone(FSH)，estradiol levels，and adverse reactions during surgery were observed and compared between the two groups esultsThe mean arterial pressure(MAP)and heartrate at 5 minutes after anesthesia(T1)，immediately after dilatation(T2)and at the end of operation(T3)in the observation group were signifi-cantly higher than those in the control group，the differences were statistically significant(P 005)The onset time of anesthesia and recoverytime after operation in the observation group were(40 50 311)s，(350 102)min，which were significantly lower than those in the controlgroup(48 83 3 29)s，(501 1 12)min，the differences were statistically significant(P 0 05)The visual analogue scale(VAS)pain scores at 6 and 12 h after operation in the observation group were(265 076)，(202 0 65)points，which were lower than those in thecontrol group(344 0 80)，(211 062)points，the differences were statistically significant(P 005)There was no significant differ-ence between the observation group and the control group in progesterone，FSH and estradiol at 1 week after operation(P 005)There was nosignificant difference between the observation group and the control group in the occurrence of body movement，respiratory depression and nauseaand vomiting during operation(P 005)The incidence of cough in the observation group was 0，which was significantly lower than that in thecontrol group(2353%)，the difference was statistically significant(P 005)ConclusionButorphanol preinjection combined with ramazo-lam has a good anesthetic effect in hysteroscopic surgery for endometrial polyps，which is helpful to stabilize hemodynamics，reduce postoperativepain，and reduce adverse reactions【Key words】Butorphanol;emazolam;Hysteroscopy