Comparison of dexmedetomidine or propofol combined with dezocine as assisted sedation in patients undergoing hysteroscopic surgery
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摘要: 目的 观察右美托咪定、丙泊酚分别与地佐辛联合静脉麻醉用于宫腔镜手术的临床效果及安全性.方法 选择宫腔镜手术适应证患者70例,随机分为右美托咪定组(D组)和丙泊酚(P组),每组35例.D组给予右美托咪啶负荷量0.8μg/kg泵注10 min后以0.2～0.6 μg/(kg·h)维持,P组给予1％异丙酚1.5mg/kg静脉注射后以4～6 mg/(kg·h)维持,镇静目标维持Ramsay镇静评分3～4分.术中持续监测心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、呼吸频率(RR)、呼气末二氧化碳分压(PETCO2)、脑电双频指数(BIS)、宫缩痛程度和镇静评分.结果 麻醉诱导后2min(T1)、扩宫颈时(T2)、膨胀宫腔后1 min(T3)P组MAP、SpO2低于D组,RR慢于D组(P＜0.05)；手术结束时(T4)时P组MAP高于D组(P＜0.05).P组睁眼时间和正确执行指令时间明显长于D组(P＜0.05),呼吸抑制发生率高于D组(P＜0.05).P组术后宫缩痛重于D组(P＜0.05).结论 右美托咪定复合地佐辛静脉麻醉镇痛效果好,宫缩痛少而轻,苏醒及定向力恢复快,无呼吸抑制,且血流动力学更平稳.
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