阿芬太尼对比舒芬太尼用于宫腔镜检查中麻醉的安全性及有效性
Journal: Basic Medical Theory Research DOI: 10.32629/bmtr.v8i1.18658
Abstract
目的：比较阿芬太尼与舒芬太尼联合丙泊酚用于宫腔镜检查麻醉的安全性及有效性,重点分析两种药物导致的呼吸抑制时长及低氧血症发生率,为临床用药选择提供依据。方法：选取2024年11月至2025年12月在大连医科大学附属第二医院行日间宫腔镜检查的192例患者,随机分为四组,其中4例拒绝签署知情同意书,3例因手术意外扩大需行腹腔镜手术并气管插管退出,3例失访,最终纳入分析182例。对照组(S组)给予舒芬太尼0.15μg/kg单次静脉注射；实验组A1组、A2组、A3组分别给予阿芬太尼5μg/kg、10μg/kg、15μg/kg单次静脉注射。2min后四组均静脉注射1.5mg/kg丙泊酚,随后以5～6mg/kg/h恒速泵注维持。记录各组呼吸抑制、低氧血症发生率,血流动力学指标,麻醉临床指标及不良反应。结果：A2组低氧血症发生率(4.3%)显著低于S组(21.4%)(P＜0.05)；A3组低氧血症、呼吸抑制发生率均显著高于A1组和A2组(P＜0.05)。与S组相比,A2组麻醉后血流动力学更稳定,术后恶心呕吐发生率更低(10.8% vs 33.3%)(P＜0.05)。A1组苏醒时间更长,术中体动发生率更高(P＜0.05)。结论：10μg/kg阿芬太尼联合丙泊酚方案镇静镇痛效果优,低氧血症发生率低,血流动力学稳定,术后并发症少,更契合日间宫腔镜手术诊疗需求。
Keywords
阿芬太尼；舒芬太尼；丙泊酚；宫腔镜检查；麻醉安全性；麻醉有效性
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[15] Shanthanna H, Ladha K S,Kehlet H, et al. Perioperative opioid administration[J].Anesthesiology,2021,134(4):645-659.
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[21] Mantz J,Abi-Jaoude F,Ceddaha A,et al.High-dose alfe ntanil for myocardial revascularization: a hemodynamic and pharmacokinetic study[J].Journal of Cardiothoracic and Vascul ar Anesthesia,1991,5(2):107-110.
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