瑞芬太尼丙泊酚不同配伍复合麻醉用于经阴道超声引导下穿刺取卵术.docVIP

瑞芬太尼丙泊酚不同配伍复合麻醉用于经阴道超声引导下穿刺取卵术的效果 宋琳 蒋茹 黄咏磊 王珊娟 俞卫锋 摘要 目的：评价瑞芬太尼和丙泊酚不同剂量组合复合应用于经阴道超声引导下穿刺取卵术麻醉的临床效果。方法：选择ASA Ⅰ~Ⅱ级择期行经阴道穿刺取卵术的患者120例，随机分为I组（瑞芬太尼1.5 mg/kg +丙泊酚1.0 mg/kg）、II组（瑞芬太尼1.5 mg/kg +丙泊酚1.5 mg/kg）、III组（瑞芬太尼1.0 mg/kg +丙泊酚1.5 mg/kg）和IV组（瑞芬太尼1.0 mg/kg +丙泊酚1.0 mg/kg），而后开始手术。根据患者体动反应和自诉疼痛情况，酌情追加瑞芬太尼和/或丙泊酚。麻醉质量评价主要指标包括患者定向力恢复时间、低氧发生率（SpO292%）及其他不良反应，此外，观察并记录患者心率（HR）、起效时间、手术时间等。结果：I组（3.94(0.91min）和IV组（4.0(1.7min）患者定向力恢复时间显著快于II组（4.88(1.26min）和III组（4.3(1.3min）患者（P0.05）；低氧和咳嗽发生率组间无差异（P0.05）。四组麻醉期间HR均较基础值显著降低（P0.05）但无患者出现心动过缓（HR50次/分）。I、II、III、IV组意识未消失但成功完成手术的病例数分别是6、0、5和10例患者。结论：丙泊酚和瑞芬太尼合用于经阴道穿刺取卵术时，患者定向力恢复时间取决于丙泊酚用量。从临床角度考虑，所有组合均具有麻醉起效和苏醒迅速的特点但临床均应加强呼吸功能监测。 主题词 麻醉，瑞芬太尼，丙泊酚，静脉麻醉，经阴道穿刺取卵术 The anesthetic efficacy of a combination of remifentanil and propofol with different dose for ultrasound-guided transvaginal oocyte retrieval. Song Lin, Jiang Ru, Huang Yonglei, Wang Shanjuan, Yu Weifeng. Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China. Corresponding Author: Yu Weifeng ywf808@yeah.net Abstract Objective To evaluate the clinical anesthetic efficacy of a combination of propofol and remifentanil with different dose for ultrasound-guided transvaginal oocyte retrieval. Methods One hundred female patients undergoing transvaginal oocyte retrieval were divided into group I, II, III and IV received intravenous bolus of remifentanil 1.5 (g/kg + propofol 1.0 mg/kg, remifentanil 1.5 (g/kg + propofol 1.5 mg/kg, remifentanil 1.0 (g/kg + propofol 1.5 mg/kg and remifentanil 1.0 (g/kg + propofol 1.0 mg/kg, respectively. The anesthesia quality evaluation were based on the following main indicators: recovery time of orientation, the incidence of hypoxemia (SpO2 92%) and adverse reactions. in addition, the patients heart rate (HR), oneset time, procedural time, etc. were also observed and recorded. Results The recovery time of orientation in the patients of group I (3.94 ( 0.91 min) and group IV (4.0 ( 1.7 min) was