子宫颈旁阻滞联合丙泊酚与芬太尼用于宫腔镜手术的临床观察OA

Objective:To observe the efficacy and safety of paracervical block(PCB)combined with Propofol and Fentanyl in hysteroscopic surgery.Method:A total of 120 female patients who were scheduled to undergo hysteroscopic surgery without intubation under general anesthesia(GA)in Yanqing District Maternal and Child Health Hospital of Beijing from February 2022 to June 2023 were selected,according to random number table method,the patients were divided into paracervical block group(PCB group)and control group(C group),with 60 cases each.Among them,the anesthesia regimen of PCB group was based on intravenous application of Propofol and Fentanyl,plus paracervical lidocaine block,while the anesthesia regimen of C group was only intravenous application of Propofol and Fentanyl,without paracervical lidocaine block.The mean arterial pressure(MAP)and heart rate(HR)of patients in the two groups were observed before surgery,after cervical dilation and immediately after surgery,the incidence of intraoperative adverse events such as hypertension,tachycardia,bradycardia,body movement and respiratory depression,the recovery time of anesthesia,the incidence and degree of uterine contraction pain after surgery,the satisfaction score of the operative and the total use of Propofol were observed between the two groups.Result:All patients successfully completed the operation.MAP and HR of patients in C group were higher than those in PCB group at cervical dilation and immediately after surgery,the differences were statistically significant(P<0.05);in C group,there were significant differences in MAP and HR in basic values,cervical dilation,and immediately after surgery(P<0.05).The incidence of intraoperative hypertension,tachycardia,body movement and respiratory depression in PCB group were lower than those in C group,the differences were statistically significant(P<0.05).The postoperative anesthesia recovery time of PCB group was shorter than that of C group,the incidence of postoperative contraction pain and postoperative VAS score were lower than those of C group,the consumption of Propofol was lower than that of C group,and the anesthetic effect score was higher than that of C group,the differences were statistically significant(P<0.05).Conclusion:Lidocaine paracervical block combined with Propofol and Fentanyl for hysteroscopic surgery has the advantages of strong intraoperative and postoperative analgesia,good circulation stability,less respiratory depression,rapid anesthesia recovery,and is a safe and effective anesthesia method.