文章摘要
不同剂量依他佐辛复合丙泊酚在无痛穿刺取卵术中效果的比较
Comparison of effect on different doses of eptazocine combined with propofol in painless oocyte retrieval
  
DOI：10.12089/jca.2025.05.011
中文关键词: 依他佐辛  丙泊酚  取卵术  体外受精-胚胎移植
英文关键词: Eptazocine  Propofol  Oocyte retrieval  In vitro fertilization and embryo transfer
基金项目:江苏省妇幼保健协会科研项目（FYX202302）；无锡市妇幼健康适宜技术推广项目（FYTG202201）；无锡市科学技术协会软课题项目（KX-24-A13）
作者单位E-mail
周洁 214002,江南大学附属妇产医院,无锡市妇幼保健院麻醉科  
秦溱 214002,江南大学附属妇产医院,无锡市妇幼保健院麻醉科  
杨秀娟 214002,江南大学附属妇产医院,无锡市妇幼保健院麻醉科  
周波 214002,江南大学附属妇产医院,无锡市妇幼保健院麻醉科  
张邓新 214002,江南大学附属妇产医院,无锡市妇幼保健院麻醉科 9812015228@jiangnan.edu.cn 
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中文摘要:
      
目的：观察和比较不同剂量依他佐辛复合丙泊酚在无痛穿刺取卵术中的效果。
方法：选择2024年3—6月因体外受精-胚胎移植行经阴道超声引导下无痛穿刺取卵术的女性患者200例，年龄20～45岁，BMI 18.5～30.0 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者分为四组：依他佐辛0.1 mg/kg组（E1组）、依他佐辛0.2 mg/kg组（E2组）、依他佐辛0.3 mg/kg组（E3组）和舒芬太尼0.1 μg/kg组（S组），每组50例。手术开始前5 min，E1组、E2组和E3组分别静脉推注依他佐辛0.1、0.2、0.3 mg/kg，S组静脉推注舒芬太尼0.1 μg/kg，均复合丙泊酚2 mg/kg行麻醉诱导，术中持续泵注丙泊酚维持麻醉。记录手术时间、麻醉时间、镇痛成功例数。记录麻醉诱导前3 min（T0）、麻醉诱导后1 min（T1）、穿刺取卵进针后即刻（T2）、进针后3 min（T3）、睁眼苏醒时（T4）、苏醒后10 min（T5）的HR、MAP、SpO2。记录丙泊酚用量、苏醒时间、定向力恢复时间、离院时间。记录术中心动过缓、低血压、呼吸抑制、术后30 min眩晕、恶心呕吐发生情况。
结果：与E1组比较，E2组、E3组和S组镇痛成功率明显升高（P<0.05）。与S组比较，E1组T1—T3时MAP明显升高，E2组T2、T3时MAP明显升高，E3组T3时MAP明显升高（P<0.05）；E1组、E2组和E3组苏醒时间、定向力恢复时间和离院时间明显缩短，术中呼吸抑制、术后30 min眩晕发生率明显降低（P<0.05）。与E3组比较，E1组和E2组离院时间明显缩短（P<0.05）。四组丙泊酚用量、术后30 min恶心呕吐发生率差异无统计学意义。
结论：与依他佐辛0.1 mg/kg比较，依他佐辛0.2、0.3 mg/kg复合丙泊酚静脉麻醉可安全有效地用于无痛穿刺取卵术，其术中镇痛效果与舒芬太尼0.1 μg/kg相似，但血压更平稳，并且术后苏醒快，不良反应少，使用依他佐辛0.2 mg/kg离院时间更短。
英文摘要:
      
Objective: To observe and compare the effect on different doses of eptazocine combined with propofol in painless oocyte retrieval.
Methods: A total of 200 female patients who underwent painless oocyte retrieval surgery due to in vitro fertilization and embryo transfer from March 2024 to June 2024, aged 20-45 years, BMI 18.5-30.0 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into four groups by random number table method: etazocine 0.1 mg/kg group (group E1), etazocine 0.2 mg/kg group (group E2), etazocine 0.3 mg/kg group (group E3), and sufentanil 0.1 μg/kg group (group S), 50 patients in each group. The patients in groups E1, E2, and E3 received intravenous injection of eptazocine at doses of 0.1, 0.2, and 0.3 mg/kg, respectively. The patients in group S received intravenous injection of sufentanil at a dose of 0.1 μg/kg. All the patients were anesthetized combined with propofol during anesthesia induction and anesthesia maintenance. The operation time, anesthesia time, and the number of successful patients of analgesia were recorded. HR, MAP, and SpO2 3 minutes before anesthesia induction (T0), 1 minute after anesthesia induction (T1), immediately after egg extraction and needle injection (T2), 3 minutes after needle injection (T3), at eye opening and recovery (T4), and 10 minutes after recovery (T5)were recorded. The dosage of propofol, awakening time, orientation recovery time, hospital discharge time were recorded. The incidence of bradycardia, hypotension, respiratory depression during the operation, and vertigo, nausea and vomiting 30 minutes after operation were recorded.
Results: Compared with group E1, the success rates of analgesia in groups E2, E3, and S were significantly increased (P < 0.05). Compared with group S, the MAP at T1-T3 in group E1 was higher (P < 0.05), the MAP at T2 and T3 in group E2 was higher (P < 0.05), the MAP at T3 in group E3 was higher (P < 0.05). Compared with group S, the awakening time, orientation recovery time, and hospital discharge time in groups E1, E2, and E3 were significantly shorter (P < 0.05), cases of respiratory depression during surgery and dizziness at 30 minutes postoperatively in groups E1, E2, and E3 was significantly fewer (P < 0.05). Compared with group E3, the off hospital time in groups E1 and E2 were shorter (P < 0.05). There were no significant differences in the dosage of propofol,and incidence of nausea and vomiting 30 minutes after the operation among the four groups.
Conclusion: Compared with eptazocin 0.1 mg/kg, intravenous anaesthesia with eptazocine 0.2 and 0.3 mg/kg combined with propofol can be used safely and effectively for outpatient painless oocyte retrieval. The intraoperative analgesia is similar to sufentanil 0.1 μg/kg, but eptazocine provides more stable blood pressure, faster postoperative recovery, and fewer adverse reactions. Moreover, eptazocine 0.2 mg/kg has a shorter hospital discharge time.
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