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奥赛利定联合丙泊酚用于无痛宫腔镜检查术的疗效观察

Efficacy of oliceridine combined with propofol for painless hysteroscopy

    摘要
  • 摘要:
    目的  探讨奥赛利定联合丙泊酚用于无痛宫腔镜检查术中的临床疗效，评估其镇痛镇静效果、呼吸安全性及不良反应情况。
    方法 选取2024年8月—2025年9月在潮州市人民医院接受全身静脉麻醉下宫腔镜检查术患者105例，随机分为3组：低剂量奥赛利定组（L组，0.02 mg/kg）、高剂量奥赛利定组（H组，0.04 mg/kg）及舒芬太尼组（S组，0.1 μg/kg），均联合丙泊酚（2 mg/kg）麻醉。研究共脱落5例，最终100例（L组34例，H组34例，S组32例）纳入分析。采用完整病例法，比较3组患者呼吸抑制发生情况、生命体征变化、丙泊酚追加用药情况及不良反应的发生率。
    结果 3组呼吸抑制发生情况差异有统计学意义（H = 10.034，P = 0.007），其中，L组的呼吸抑制程度低于H组及S组（P分别为0.047、0.009），而H组与S组间差异无统计学意义（P ＞ 0.05）。按严重程度分层比较，L组低氧血症（SpO2 ＜ 90%）及以上发生率低于S组（29.4% vs. 68.8%，P ＜ 0.017）。3组丙泊酚追加例数及追加总剂量差异均无统计学意义（P均 ＞ 0.05），头晕发生率分别为2.9%、5.9%及0.0%，组间差异无统计学意义（P ＞ 0.05）。3组平均动脉压、心率及呼吸频率随时间均出现下降趋势，但组间比较差异无统计学意义（均P ＞ 0.05）。
    结论 低剂量奥赛利定联合丙泊酚用于无痛宫腔镜检查术，可在保证镇静深度的同时，降低呼吸抑制程度，且低氧血症发生率较低，具有较高的呼吸安全性与临床应用价值。

     

    Abstract:
    Objective To investigate the clinical efficacy of oliceridine combined with propofol in painless hysteroscopy, and to evaluate its analgesic and sedative effects, respiratory safety and adverse reactions.
    Methods A total of 105 patients who underwent hysteroscopy under general intravenous anesthesia in Chaozhou People's Hospital from August 2024 to September 2025 were selected and randomly divided into three groups: low-dose oliceridine group (Group L, 0.02 mg/kg), high-dose oliceridine group (Group H, 0.04 mg/kg) and sufentanil group (Group S, 0.1 μg/kg), all combined with propofol anesthesia (2 mg/kg). A total of 5 cases were excluded (surgical duration exceeding 30 min), and finally 100 cases were included (34 cases in Group L, 34 cases in Group H and 32 cases in Group S). A complete-case analysis was used to compare the severity of respiratory depression, changes in vital signs, additional propofol use, and the incidence of adverse reactions among the three groups.
    Results There was a statistically significant difference in the incidence of respiratory depression among the three groups (H = 10.034, P = 0.007). Pairwise comparisons showed that the severity of respiratory depression was lower in Group L than in Group H and Group S (P = 0.047 and 0.009, respectively), while there was no statistically significant difference between Group H and Group S (P ＞ 0.05). In a stratified analysis by severity, the proportion of patients with hypoxemia (SpO2 ＜ 90%) or above was lower in Group L than in Group S (29.4% vs. 68.8%, P ＜ 0.017). There was no statistically significant difference in the number of patients requiring additional propofol or the additional propofol dose among the three groups (both P ＞ 0.05), and the incidence of dizziness was 2.9%, 5.9% and 0.0% respectively, with no statistically significant difference among groups (P ＞ 0.05). There was a downward trend in MAP, HR, and RR over time in all three groups; however, no statistically significant differences between groups (all P ＞ 0.05).
    Conclusions Low-dose oliceridine (0.02 mg/kg) combined with propofol in painless hysteroscopy can significantly reduce the severity of respiratory depression while ensuring the depth of sedation, which has high respiratory safety and clinical application value.

     

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