文章摘要
磷丙泊酚二钠与丙泊酚在宫腔镜检查中镇静效果的比较
Comparison of sedative effects between fospropofol disodium and propofol in hysteroscopic examination
  
DOI：10.12089/jca.2026.03.008
中文关键词: 磷丙泊酚二钠  丙泊酚  宫腔镜  镇静  血流动力学  不良反应
英文关键词: Fospropofol disodium  Propofol  Hysteroscopy  Sedation  Hemodynamics  Adverse reactions
基金项目:安徽省卫生健康科研项目重点项目（AHWJ2024Aa10018）
作者单位E-mail
汤玮洁 230000,合肥市,安徽医科大学第一附属医院麻醉科  
李薇 230000,合肥市,安徽医科大学第一附属医院麻醉科  
尚子祥 230000,合肥市,安徽医科大学第一附属医院麻醉科  
刘学胜 230000,合肥市,安徽医科大学第一附属医院麻醉科  
沈启英 230000,合肥市,安徽医科大学第一附属医院麻醉科 shenqiying@ahmu.edu.cn 
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中文摘要:
      
目的： 评价磷丙泊酚二钠对门诊宫腔镜检查患者镇静的有效性及安全性。
方法： 选择择期行门诊无痛宫腔镜检查的患者，年龄18～64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三组：磷丙泊酚二钠12.5 mg/kg组（F1组）、磷丙泊酚二钠15 mg/kg组（F2组）和丙泊酚2 mg/kg组（P组）。麻醉诱导时，F1组、F2组分别予以磷丙泊酚二钠12.5 mg/kg和15 mg/kg，P组给予丙泊酚2 mg/kg 。主要指标为镇静成功率。次要指标包括意识消失时间，睁眼时间，麻醉诱导前、诱导后1、5 min、扩宫颈时和手术结束时的HR和MAP。不良反应包括给药后注射痛、瘙痒、异常感觉、术后眩晕、术中术后明显体动、苏醒后即时腹部痛（下腹疼痛）、术后腹胀、呼吸抑制/呛咳、低血压和苏醒20 min后腹部痛（术后宫缩痛）。
结果： 共纳入患者81例，其中F1组28例，F2组24例，P组29例。与F1组比较，P组意识消失时间明显缩短，麻醉诱导后1、5 min、手术结束时HR明显减慢，麻醉诱导后1 min MAP明显降低，注射痛、术后眩晕发生率明显升高，瘙痒和异常感觉发生率明显降低（P<0.05）；F2组麻醉诱导后1 min HR明显减慢，麻醉诱导后5 min MAP明显降低（P<0.05）。与F2组比较，P组意识消失时间和睁眼时间明显缩短，麻醉诱导后5 min HR明显减慢，麻醉诱导后5 min、手术结束时MAP明显升高，注射痛、体动和下腹疼痛发生率明显升高，瘙痒和异常感觉发生率明显降低（P<0.05）。三组镇静成功率差异无统计学意义。
结论： 磷丙泊酚二钠12.5、15 mg/kg均可为无痛宫腔镜的患者提供满意的镇静效果，且不良反应发生率较低；磷丙泊酚二钠12.5 mg/kg在提供同样镇静效果的同时对患者的循环影响更小。
英文摘要:
      
Objective: To evaluate the efficacy and safety of fospropofol disodium for sedation in patients undergoing hysteroscopy examination.
Methods: Patients who underwent elective painless office hysteroscopy examination, aged 18-64 years, BMI 18.5-30.0 kg/m2, ASA physical status Ⅰ or Ⅱ were enrolled. They were divided into three groups using a random number table method: the fospropofol disodium 12.5 mg/kg group (group F1), the fospropofol disodium 15 mg/kg group (group F2), and the propofol 2 mg/kg group (group P). During anesthesia induction, groups F1 and F2 were respectively administered fospropofol disodium 12.5 mg/kg and 15 mg/kg, while group P received propofol 2 mg/kg. The primary outcome was the incidence of successful sedation. Secondary outcomes included time to loss of consciousness, time to eye opening, HR and MAP measured before anesthesia induction, at 1 and 5 minutes after induction, during cervical dilation, and at the end of surgery. Adverse reactions included post-administration injection pain, pruritus, abnormal sensations, postoperative dizziness, intraoperative and postoperative body movement, immediate abdominal pain (lower abdominal pain) upon awakening, postoperative abdominal distension, respiratory depression or retching, hypotension, and abdominal pain 20 minutes after awakening (postoperative uterine contraction pain).
Results: Eighty-one patients were enrolled in this study, 28 patients in group F1, 24 patients in group F2, and 29 patients in group P. Compared with group F1, the time to loss of consciousness was significantly shortened, HR at 1 minute and 5 minutes after anesthesia induction and at the end of surgery, MAP at 1 minute after anesthesia induction were significantly decreased, the incidences of injection pain and postoperative dizziness were significantly increased, and the incidences of pruritus and abnormal sensations were significantly decreased in group P (P < 0.05), HR at 1 minute after anesthesia induction and MAP at 5 minutes after anesthesia induction were significantly decreased in group F2 (P < 0.05). Compared with group F2, the time to loss of consciousness and the time to eye opening was significantly shortened, HR at 5 minutes after anesthesia induction was significantly decreased, MAP at 5 minutes after anesthesia induction and at the end of surgery were significantly increased, the incidences of injection pain, body movement, and lower abdominal pain were significantly increased, and the incidences of pruritus and abnormal sensations were significantly decreased in group P (P < 0.05). There were no significantly differences in the incidence of successful sedation among the three groups.
Conclusion: Both fospropofol disodium 12.5 mg/kg and 15 mg/kg can provide satisfactory sedation effects for patients undergoing painless hysteroscopy with a lower incidence of adverse reactions, the dose of fospropofol disodium 12.5 mg/kg has less impact on the patient's circulation while delivering equivalent sedation efficacy.
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