骶管阻滞与静脉麻醉用于宫腔镜检查比较研究.docVIP

骶管阻滞与静脉麻醉用于宫腔镜检查比较研究 　　摘要：目的 比?^骶管阻滞与静脉麻醉用于宫腔镜检查的麻醉效果，对血流动力学的影响。方法 选择非住院行宫腔镜检查100例，随机分为两组，C组（骶管阻滞）：经骶管注入0.75%盐酸罗哌卡因注射液7 ml+2%盐酸利多卡因注射液2.5 ml+枸橼酸舒芬太尼注射液0.1 μg/kg+0.9%氯化钠注射液15.5 ml混合液共计25 ml；I组（静脉麻醉）：枸橼酸舒芬太尼注射液0.1～0.2 μg/kg、丙泊酚注射液1.5～2.5 mg/kg复合静脉麻醉。观察并记录患者麻醉起效时间、镇痛持续时间、平均动脉压（MAP）、心率（HR）、血氧饱和度（SPO2）、宫颈松弛情况、术后2 h内镇痛效果、镇痛药物使用情况及不良反应发生的情况和麻醉费用。结果 C组和I组有效镇痛率均在90%以上，I组患者麻醉起效时间、镇痛持续时间短于C组，P0.05。I组较C组平均动脉压、心率、血氧饱和度波动明显，P0.05。C组较I组患者宫颈松弛好，P0.05。术后VAS评分在术后30 min及术后1 h时I组患者明显高于C组，P0.05。I组患者麻醉费用较C组患者麻醉费用高， P0.05。结论 骶管阻滞麻醉镇痛效果确切，对血流动力学影响轻微，宫颈松弛好，更加安全可靠及费用低等优点，值得在基层医院推广。 　　关键词：骶管阻滞；静脉麻醉；宫腔镜检查；罗哌卡因 　　中图分类号：R614；R445 文献标识码：A 文章编号：1006-1959（2017）24-0037-04 　　Comparative Study of Sacral Block and Intravenous Anesthesia for Hysteroscopy 　　LV Zhong-jie，CUI Bao-juan，SHEN Hong-bo，MIAO Guo-qing 　　（Department of Anesthesiology，Beijing Wuzhou Women and Childrens Hospital，Beijing 100022，China） 　　Abstract：Objective To compare the sacral block anesthesia and intravenous anesthesia for hysteroscopy，effects on hemodynamics.Methods Outpatient hysteroscopy in 100 cases，were randomly divided into two groups，group C （sacral block）：Intraperitoneal injection of 0.75% Ropivacaine hydrochloride injection 7 ml+2% lidocaine hydrochloride injection 2.5 ml+sufentanyl citrate injection 0.1 μg/kg+0.9% sodium chloride injection 15.5 ml mixed Fluid total of 25 ml；Group I（intravenous anesthesia）：citrate sufentanil injection 0.1～0.2 μg/kg，propofol injection 1.5～2.5 mg/kg combined intravenous anesthesia.Observe and record the onset time，duration of analgesia，mean arterial pressure（MAP），heart rate（HR），oxygen saturation（SPO2）， cervical relaxation，analgesia effect within 2 h after operation，the use of analgesic drugs and the adverse reaction and the cost of anesthesia.Results The effective analgesic rates of group C and group I were all above 90%.The onset time of anesthesia and the duration of analgesia in group I were shorter than those in group C，P 　　Key words：Sacral block；Intravenous anesthesia；Hysterosco