黄姣艳 张媛

*基金项目：江西省卫生健康委科技计划项目（202310855）

【摘要】 目的：研究不同剂量阿芬太尼在无痛取卵术中的应用效果。方法：选择2022年8月—2023年8月于井冈山大学附属医院行无痛取卵术的200例患者，按随机数字表法将其分为P组、A1组、A2组、A3组，各50例。A1组采用5 μg/kg阿芬太尼复合丙泊酚麻醉，A2组采用7 μg/kg阿芬太尼复合丙泊酚麻醉，A3组采用9 μg/kg阿芬太尼复合丙泊酚麻醉，P组采用丙泊酚麻醉。比较四组血流动力学[平均动脉压（MAP）、心率（HR）]、苏醒时间、达离院标准时间、取卵时间、不良反应及满意度。结果：T0、T1、T2时，四组MAP及HR水平比较，差异均无统计学意义（P>0.05）。A1组、A2组与A3组的苏醒时间、达离院标准时间均短于P组，A1组、A2组的呼吸抑制发生率低于P组与A3组，A2组与A3组的体动发生率低于P组与A1组，A1组、A2组与A3组的满意度均高于P组，差异均有统计学意义（P<0.05）。A1组、A2组与A3组的苏醒时间、达离院标准时间及满意度比较，四组取卵时间、恶心呕吐发生率比较，A1组与A2组呼吸抑制发生率比较，A2组与A3组的体动发生率比较，差异均无统计学意义（P>0.05）。结论：无痛取卵术中采用7 μg/kg阿芬太尼复合丙泊酚麻醉效果良好，患者术后苏醒质量良好、满意度高，且患者血流动力学无明显变化，可减少不良反应的发生。

【关键词】 无痛取卵术 不同剂量阿芬太尼 丙泊酚 血流动力学 满意度

Application Study on the Different Doses of Alfentanil in Painless Egg Extraction Surgery/HUANG Jiaoyan， ZHANG Yuan. //Medical Innovation of China， 2024， 21（15）： 0-051

[Abstract] Objective： To study the application effect of different doses of Alfentanil in painless egg retrieval surgery. Method： A total of 200 patients who underwent painless egg retrieval surgery in Jinggangshan University Affiliated Hospital from August 2022 to August 2023 were selected and divided into group P and group A1， group A2， group A3 according to the random number table method， with 50 cases in each group. Group A1 adopted 5 μg/kg Alfentanil combined with Propofol anesthesia， group A2 used 7 μg/kg Alfentanil combined with Propofol anesthesia， group A3 used 9 μg/kg Alfentanil combined with Propofol anesthesia， while group P was anesthetized with Propofol. The hemodynamics [mean arterial pressure （MAP）， heart rate （HR）]， recovery time， time to reach hospital discharge standard， egg retrieval time， adverse reactions and satisfaction of four groups were compared. Result： At T0， T1， T2， there were no statistically significant differences in MAP and HR levels among the four groups （P>0.05）. The recovery time and time to reach hospital discharge standard in group A1， group A2 and group A3 were shorter than those in group P， the incidences of respiratory depression in group A1 and group A2 were lower than those in group P and group A3， the incidences of body movement in group A2 and group A3 were lower than those in group P and group A1， and the satisfaction of group A1， group A2 and group A3 was higher than that in group P， the differences were statistically significant （P<0.05）. There were no significant differences in the recovery time， time to reach hospital discharge standard and satisfaction of group A1， group A2 and group A3， the time of egg retrieval， the incidence of nausea and vomiting of four groups， the incidence of respiratory depression between group A1 and group A2， and the incidence of body movement between group A2 and group A3 （P>0.05）. Conclusion： The anesthesia effect in painless egg retrieval surgery of Alfentanil using 7 μg/kg combined with Propofol is good， and the postoperative recovery quality of patients is good， with high satisfaction， and there is no significant change in patient's hemodynamics， which can reduce the occurrence of adverse reactions.

[Key words] Painless egg retrieval surgery Different doses of Alfentanil Propofol Hemodynamics Satisfaction

First-author's address： Anesthesiology Department， Jinggangshan University Affiliated Hospital， Jian 343000， China

doi：10.3969/j.issn.1674-4985.2024.15.011

不孕症是指一对配偶性生活规律，且未采取任何避孕措施但至少1年以上未孕，其已成为影响人类发展及健康的全球性生殖健康问题[1]。人类辅助生殖技术（ART）主要包括人工授精、体外受精-胚胎移植（IVF-ET）及其衍生技术，其中IVF-ET已成为解决不孕症的主要手段[2-3]。超声引导下经阴道穿刺取卵术（TVOR）是整个IVF-ET过程中最为关键的一步，取卵过程中患者疼痛剧烈，患者往往由于疼痛无法配合，会使手术风险增加[4-5]。近年……