Propofol Combined With Different Doses Of Alfentanil In Application Research Of Hysteroscopic Surgery Anesthesia

Objective:By discussing the safety and effectiveness of propofol combined with different doses of alfentanil in non-intubated total intravenous anesthesia during hysteroscopic surgery,it provides a reference for the clinical use of alfentanil in daytime hysteroscopic surgery.Methods:After approval by the hospital ethics committee,patients who met the requirements for hysteroscopic surgery from October 2021 to October 2022 were selected.According to the inclusion criteria and exclusion criteria,90 patients were finally collected and randomly divided into 3 groups,30 cases in each group.Group A:fentanyl 1μg/kg+propofol 2.0 mg/kg/min,group B:alfentanil 5μg/kg+propofol 2.0 mg/kg/min,group C:alfentanil 10μg/kg+propofol2.0 mg/kg/min,until the modified observer’s assessment of alertness/sedation（MOAA/S）score was 0.Anesthesia maintenance:propofol 4-6 mg/kg/h intravenous infusion.The postoperative analgesic effect was recorded.Visual analogue scale（VAS）was used to evaluate the degree of pain at 5 min,10 min and 20 min after waking up.The incidence of respiratory depression,intraoperative body movement and the total dosage of propofol in each group were recorded.Mean arterial pressure（MAP）,heart rate（HR）,pulse oxygen saturation（Sp O₂）and respiratory rate（RR）were recorded before injection（T₀）,when eyelash reflex disappeared（T₁）,at the beginning of operation（T₂）,10 min after operation（T₃）,at the end of operation（T₄）and after recovery（T₅）.The onset time of anesthesia,duration of operation,recovery time of consciousness and awake time were recorded.The occurrence of adverse reactions such as postoperative nausea and vomiting was recorded.Results:According to the exclusion criteria,28 patients in group A,30 patients in group B,and 30patients in group C completed the experimental study.（1）There was no significant difference between respiratory depression,intraoperative body movement,nausea and vomiting,5 min VAS,10 min VAS,and 20 min VAS（P>0.05）.（2）In terms of onset time,group C was shorter than group A and group B,and the difference was statistically significant（P<0.05）;in terms of recovery time,group C was significantly shorter than group A,and the difference was statistically significant（P<0.05）.（3）The RR of group B was significantly higher than that of group A and group C at T₁,T₂,T₃ and T₄;At T₄,the Sp O₂ of group B was significantly lower than that of group A and group.The heart rate of group B was significantly lower than that of group A and group C at T₂,the heart rate of group C was significantly higher than that of group A and group B at T₃,and the heart rate of group A was significantly lower than that of group B and group C at T₅.The MAP of group B was significantly higher than that of group A and group C at T₁,and the MAP of group C was significantly lower than that of group A and group B at T₅.The difference was statistically significant（P<0.05）.Conclusion:1.The combination of alfentanil and propofol for hysteroscopic anesthesia is a safe and effective suitable matching program.2.When combined with propofol,in terms of the onset time of non-intubated total intravenous anesthesia in hysteroscopic surgery,alfentanil 10μg/kg is superior to the combination of alfentanil 5μg/kg and fentanyl 1μg/kg.