[1]刘英伟.不同剂量地佐辛联合丙泊酚麻醉对经阴道超声引导下无痛取卵术患者妊娠结局的影响[J].新乡医学院学报,2021,38(12):1141-1146.[doi:10.7683/xxyxyxb.2021.12.007]
 LIU Yingwei.Effect of different doses of dezocine combined with propofol on the pregnancy outcome of patients undergoing painless egg retrieval under transvaginal ultrasound guidance[J].Journal of Xinxiang Medical University,2021,38(12):1141-1146.[doi:10.7683/xxyxyxb.2021.12.007]
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不同剂量地佐辛联合丙泊酚麻醉对经阴道超声引导下无痛取卵术患者妊娠结局的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年12
页码:
1141-1146
栏目:
临床研究
出版日期:
2021-12-05

文章信息/Info

Title:
Effect of different doses of dezocine combined with propofol on the pregnancy outcome of patients undergoing painless egg retrieval under transvaginal ultrasound guidance
作者:
刘英伟
(珠海市妇幼保健院麻醉科,广东 珠海 519001)
Author(s):
LIU Yingwei
(Department of Anesthesiology,Zhuhai Maternal and Child Health Hospital,Zhuhai 519001,Guangdong Province,China)
关键词:
地佐辛丙泊酚取卵术性激素妊娠结局
Keywords:
dezocinepropofolegg retrievalsex hormonespregnancy outcome
分类号:
R71
DOI:
10.7683/xxyxyxb.2021.12.007
文献标志码:
A
摘要:
目的 探讨不同剂量地佐辛联合丙泊酚对经阴道超声引导下无痛取卵术患者妊娠结局的影响。方法 选择2018年12月至2019年12月于珠海市妇幼保健院生殖中心行体外受精-胚胎移植技术(IVF-ET)的240例不孕女性患者为研究对象,按随机数字表法将患者分为A、B、C组,每组80例。3组患者均采用促性腺激素释放激素激动剂长方案促排卵,当出现优势卵泡后,行经阴道超声引导下取卵术;术前禁食12 h、禁水6 h,A组患者静脉注射1.00 μg·kg-1芬太尼和2.00 mg·kg-1丙泊酚麻醉,B组患者静脉注射0.05 mg·kg-1地佐辛和2.00 mg·kg-1丙泊酚麻醉,C组患者静脉注射0.10 mg·kg-1地佐辛和2.00 mg·kg-1丙泊酚麻醉,应用8.00~12.00 mg·kg-1·h-1丙泊酚静脉维持麻醉;根据3组患者术中体动及睁眼情况适当追加0.5~1.0 mg·kg-1丙泊酚;取卵后进行体外受精,选取优质胚胎进行胚胎移植。记录并比较3组患者手术时间、麻醉时间、丙泊酚用量等手术中指标。采用视觉模拟评分法评估患者术后疼痛程度。分别于人绒毛膜促性腺激素(HCG)注射日、胚胎移植(ET)日清晨抽取3组患者空腹静脉血,应用ARCHITECT i2000SR电化学发光免疫系统检测血清黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平。记录并比较3组患者取卵术后恶心、呕吐、呼吸抑制、眩晕等不良反应,以及受精卵率、卵裂率、优质胚胎率、临床妊娠率、自然流产率、活产率等妊娠结局。结果 3组患者手术时间比较差异无统计学意义(F=0.699,P>0.05)。B组和C组患者的麻醉时间显著短于A组,丙泊酚用量显著少于A组,术后疼痛感显著轻于A组(P<0.05);C组患者的麻醉时间显著短于B组,丙泊酚用量显著少于B组,术后疼痛感显著轻于B组(P<0.05)。HCG注射日、ET日,3组患者LH、E2、P水平比较差异无统计学意义(P>0.05);3组患者ET日血清LH、E2水平显著低于HCG注射日,P水平显著高于HCG注射日(P<0.05)。A组患者发生恶心4例,呕吐8例,呼吸抑制6例,眩晕5例,不良反应发生率为28.75%(23/80);B组患者发生恶心2例,呕吐2例,呼吸抑制3例,眩晕5例,不良反应发生率为15.00%(12/80);C组患者发生恶心2例,眩晕2例,不良反应发生率为4.00%(4/80)。B组和C组患者的不良反应发生率显著低于A组,C组患者的不良反应发生率显著低于B组(χ2=4.425、16.085、4.444,P<0.05)。3组患者的受精卵率、卵裂率、优质胚胎率、临床妊娠率、自然流产率、活产率比较差异均无统计学意义(χ2=0.043、0.000、0.025、0.639、0.078、0.100,P>0.05)。结论 0.1 mg·kg-1地佐辛用于IVF-ET取卵术可显著减轻术后疼痛,降低丙泊酚用量,缩短麻醉时间,减少不良反应的发生,且不影响患者性激素水平和妊娠结局。
Abstract:
Objective To investigate the effect of different doses of dizocine combined with propofol on pregnancy outcome of patients undergoing painless egg retrieval under transvaginal ultrasound guidance.Methods A total of 240 infertile female patients who underwent in vitro fertilization embryo transfer (IVF-ET) in the Reproductive Center of Zhuhai Maternal and Child Health Hospital from December 2018 to December 2019 were selected as the research objects.The patients were randomly divided into group A,group B and group C,with 80 cases in each group.All the patients in the three groups were treated with gonadotropin-releasing hormone to promote ovulation.When dominant follicles appeared,transvaginal ultrasound-guided egg removal was performed;the patients in group A were anesthetized by intravenous injection of 1.00 μg·kg-1 fentanyl and 2.00 mg·kg-1 propofol,the patients in group B were anesthetized by intravenous injection of 0.05 mg·kg-1 dizocine and 2.00 mg·kg-1 propofol,and the patients in group C were anesthetized by intravenous injection of 0.10 mg·kg-1 dizocine and 2.00 mg·kg-1 propofol,and then maintained anesthesia by intravenous injection of 8.00-12.00 mg·kg-1·h-1 propofol;and 0.5-1.0 mg·kg-1 propofol was added intraoperatively according to the body movement and eye opening of the patients in the three groups.The eggs were fertilized in vitro,and high-quality embryos were selected for embryo transfer(ET).The operation time,anesthesia time,propofol dosage of patients in the three groups were recorded and compared.The postoperative pain was evaluated by visual analogue scale.The fasting venous blood of patients in the three groups were collected on the human chorionic gonadotropin (HCG) injection day and ET day,respectively.The levels of serum luteinizing hormone (LH),estradiol (E2) and progesterone (P) were detected by ARCHITECT i2000SR electrochemiluminescence immune system.The adverse reactions such as nausea,vomiting,respiratory depression and dizziness after ovectomy,as well as the pregnancy outcomes such as fertilized egg rate,cleavage rate,high-quality embryo rate,clinical pregnancy rate,spontaneous abortion rate and live birth rate were recorded and compared.Results There was no significant difference in operation time among the three groups (F=0.699,P>0.05).the anesthesia time in group B and group C was significantly shorter than that in group A,the dosage of propofol was significantly less than that in group A,and the postoperative pain was significantly lighter than that in group A(P<0.05);the anesthesia time in group C was significantly shorter than that in group B,the dosage of propofol was significantly less than that in group B,and the postoperative pain was significantly lighter than that in group B (P<0.05).There was no significant difference in the levels of serum LH,E2 and P among the three groups on the day of HCG injection and ET (P>0.05);the levels of serum LH and E2 on the day of ET in the three groups were significantly lower than those on the day of HCG injection,and the level of serum P was significantly higher than that on the day of HCG injection(P<0.05).In group A,there was 4 cases of nausea,8 cases of vomiting,6 cases of respiratory depression and 5 cases of vertigo;the incidence of adverse reactions was 28.75% (23/80).In group B,there was 2 cases of nausea,2 cases of vomiting,3 cases of respiratory depression and 5 cases of vertigo;the incidence of adverse reactions was 15.00% (12/80).In group C,there was 2 cases of nausea and 2 cases of vertigo;the incidence of adverse reactions was 4.00% (4/80).The incidence of adverse reactions of patients in group B and group C was significantly lower than that in group A(χ2=4.425,16.085;P<0.05),and the incidence of adverse reactions in group C was significantly lower than that in group B (χ2=4.444,P<0.05).There was no significant difference in fertilized egg rate,cleavage rate,high-quality embryo rate,clinical pregnancy rate,spontaneous abortion rate and live birth rate among the three groups (χ2=0.043,0.000,0.025,0.639,0.078,0.100;P>0.05).Conclusion 0.10 mg·kg-1 dezocine has a good anesthesia effect for oocyte retrieval,which can alleviate the dosage of propofol,reduce the occurrence of postoperative adverse reactions,and does not affect the level of sex hormones and the pregnancy outcome.

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更新日期/Last Update: 2021-12-05