| Objective:The purpose of this study is to evaluate the clinical effects of different anesthesia methods in hysteroscopic surgery.Method:90 patients who underwent hysteroscopic surgery in our hospital from November 2018 to November 2019 were selected as the research objects.Among them,the age was 25 to 50 years,the weight was 45 to 75kg,and the operation time was about 20 to 45 minutes.ASA is classified as Ⅰ～Ⅱ.And 90 patients in this experiment were randomly divided into 3 groups:group A,group B and group C,each group had 30 patients.For experimental group A,we used target-controlled infusion of remifentanil and dexmedetomidine combined with low-dose midazolam for intravenous anesthesia.For experimental group B,we used target-controlled infusion of remifentanil and Dexmedetomidine combined with low-dose propofol for intravenous anesthesia.For control group C,we used target-controlled infusion of remifentanil and dexmedetomidine for intravenous anesthesia.The patien’s surgical heart rate(HR),mean arterial blood pressure(MAP),Saturation of blood oxygen(SpO2),and Bispectral idex(BIS)were determined and compared.We recorded the above experimental indexes at different time,including before anesthesia(T0),5min after anesthesia(T1),compound midazolam or propofol time(T2),the moment the cervical dilation operation begins(T3),the moment of dilated uterine cavity(T4),the beginning of the operation of the uterine cavity(T5)and the end of the operation(T6),etc.During the operation,we observed and recorded the patient’s adverse reactions such as body movement,respiratory depression,dizziness,nausea,vomiting,and contraction pain.At the same time,we investigated the patient’s and doctor’s satisfaction with the anesthesia effect in this experiment,and calculated the total amount of remifentanil used by each patient in this study.Result:In this study,the time of anesthesia induction and the total amount of remifentanil in group A and group B were both lower than those in group C(P<0.05),and the difference was statistically significant;The MAP and HR of group A and group B were lower than those of group C(P<0.05),and the difference was statistically significant.The vital signs of group A and group B were more stable than those of group C.In this study,the level of BIS was used to evaluate the depth of anesthesia and the degree of arousal during the operation.In both groups A and B,BIS T2-BIS T5 was lower than that in group C(P<0.05),and the difference was statistically significant;Group A’s BIS T3-T6 levels are all lower than group B(P<0.05 with statistical significance),which implies that A expresses lower BIS level than B in uterine cervix expansion,uterus distention and uterine operation with a deeper level of anesthesia of group A.After surgery(T6),BIS in group B was relatively high,which may be more easy to wake up,but BIS in group A and group B could be awakened within the range of awake,superficial sedation and anesthesia;Compared with group A and group B,the incidence of limb movement,respiratory depression and suspension of surgery due to poor anesthetic effect were significantly increased in group C(P<0.05).The difference was statistically significant;Compared with group A and group B,patients in group C had A higher incidence of postoperative adverse reactions such as dizziness,nausea and pain(P<0.05),and the difference was statistically significant;Compared with group A and group B,the degree of anesthesia satisfaction of surgeons and patients in group C was lower(P<0.05),and the difference was statistically significant.Conclusion:Remifentanil and dexmedetomidine combined with low-dose midazolam or propofol are more effective for hysteroscopic anesthesia,patients’ life-related signs are relatively stable,and the chance of adverse reactions is less.Doctors and patients are more satisfied with the operation,and it is easier for patients to wake up after the operation.The above anesthesia methods are worth popularizing in anesthesia for hysteroscopic surgery. |
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