Objective To investigate the clinical efficacies of laryngeal mask anesthesia combined with fast-track surgery concept,intravenous anesthesia and subarachnoid block(spinal anesthesia) for hysteroscopic surgery.Methods A total of 150 ASA Ⅰ-Ⅱ patients scheduled for hysteroscopic surgery were randomly divided into three groups:spinal anesthesia group(group A,n=50),intravenous anesthesia group (group B,n =50) and laryngeal mask anesthesia group (group C,n=50).Mean arterial pressure(MAP) and heart rate(HR) were determined before administration (T1),5 minutes after administration(T2),5 minutes after the start of surgery(T3),and at the end of surgery(T4).Furthermore,intraoperative incidence of nausea,vomiting and respiratory depression,postoperative incidence of complications,patient satisfaction,time to off-bed activity,length of hospital stay,and hospitalization costs were recorded.Moreover,VAS scores were measured at 2,6,12 and 24 hours after operation.Results Compared with T1,MAP decreased and HR increased at T2 in group A,but both MAP and HR decreased at T2 in group B and group C(P＜ 0.05).Compared with group A,MAP increased and HR decreased in group B and group C at T2 and T3 (P＜0.05).In addition,compared with group A,intraoperative incidence of nausea,vomiting and respiratory depression and postoperative incidence of complications decreased and patient satisfaction increased in group C(P＜0.05).Compared with group B,time to off-bed activity increased in group A but decreased in group C(P＜0.05).At 2,6 and 12 hours after operation,VAS scores decreased in group C,compared with group A and group B(P＜0.05).Conclusion Laryngeal mask anesthesia combined with fast-track surgery concept for hysteroscopic surgery can improve anesthetic efficacy,reduce postoperative pain,shorten recovery time and increase patient satisfaction.%目的 探讨喉罩插管全身麻醉联合快速康复理念、非插管静脉全身麻醉与蛛网膜下腔阻滞(腰麻)用于宫腔镜手术的临床效果.方法 选取择期行宫腔镜手术患者150例(ASA Ⅰ-Ⅱ级)随机分成3组:A组为腰麻组,B组为非插管静脉全身麻醉组,C组为喉罩插管静脉全身麻醉组,每组50例;记录给药前(T1)、给药后5 min(T2)、手术开始后5 min(T3)和手术结束时(T4)平均动脉压(MAP)值和心率(HR)值;记录术中出现恶心呕吐、呼吸抑制、术后并发症例数及患者满意度;记录术后活动时间、住院时间、住院总费用;记录术后各时点(2、6、12、24 h)疼痛视觉模拟评分(VAS)评分.结果 与同组T1比较,A组T2时刻MAP值更低、HR值更高,而B组、C组T2时刻MAP值和HR值都更低(P＜0.05);与A组T2、T3比较,B组与C组T2、T3时刻MAP值更高、HR值更慢(P＜0.05);C组术中恶心呕吐、呼吸抑制、术后并发症发生率比A组更低,患者满意度优于A组(P＜0.05);C组呼吸抑制发生率低于B组,患者满意度比B组更高(P＜0.05);B组和C组的住院时间、术后活动时间均比A组更短,而C组术后活动时间比B组更短(P＜0.05);C组术后2、6和12 h疼痛VAS评分值比A组和B组同时间点疼痛VAS评分值均更低(P＜0.05).结论 喉罩全身麻醉联合快速康复理念用于宫腔镜手术麻醉效果更佳、术后疼痛评分更低、康复时间更短并且患者满意度更高.
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