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Zhang Jingwen, 1 Kong Lingling, 2 Juan11Department of Anesthesiology, West China Second Hospital, Sichuan University, Key Laboratory for Congenital Defects and Related Diseases, Ministry of Education, Sichuan University, Chengdu, Sichuan Province, 2Department of Obstetrics and Gynecology, West China Second ʻO ka Halemai o ke Kulanui ʻo Sichuan, nā kīnā hānau, Key Laboratory of Sichuan University of Education and Related Diseases of the Ministry of Education, Chengdu, Sichuan Province Ka mea kākau kūpono: Ni Huang, Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Congenital Defects a me nā maʻi makuahine a me nā keiki o ke Kuhina Hoʻonaʻauao o ke Kulanui ʻo Sichuan, South San Renmin Road, Chengdu, Sichuan Province Duan 20, 610041 Kina, Tel +86 18180609890, Fax +86 28855503752, Email [email protected] Ke kumu: Ua hoʻolālā ʻia kēia haʻawina e ho'āʻo i ka mean effective dose (ED50) a me 95% pono o ka lidocaine intravenous i lawelawe ʻia ma nā ʻano like ʻole.(ED95), ka hopena o ka induction dose o propofol, a me ka hoʻoholo ʻana i ka hopena maikaʻi loa.Pūʻulu: saline (L0), lidocaine 0.5 mg / kg (L0.5), lidocaine 1.0 mg / kg (L1.0) a me lidocaine 1.5 mg / kg (L1.5).Hoʻoulu i ka anesthesia me 1.0 µg/kg fentanyl.Hāʻawi ʻia ka lidocaine a i ʻole saline i hoʻomākaukau ʻia ma hope e like me ke kuhikuhi ʻana, a ukali ʻia e propofol.Hoʻoholo ʻia ka nui o ka propofol no kēlā me kēia maʻi me ka hoʻohana ʻana i kahi hoʻolālā haʻawina ma luna.ʻO nā mea hope mua ka ED50 a me ED95 o ka propofol induction dose. Ua hoʻopaʻa ʻia ka nui o ka propofol doses, ka manawa ala, a me nā hanana ʻino. Nā hopena: ʻO ka ED50 (95% confidence interval) o propofol i haʻahaʻa loa i nā hui L1.0 a me L1.5 ma mua o ka hui L0 (1.6 [1.5-1.7] mg / kg a me 1.8 [1.6-1.9] mg / kg, me ka 2.4 [2.3-2.5] mg / kg, p1.0 a me L1.5 (p> 0.05) Eia naʻe, he mea kupanaha, ua kiʻekiʻe loa ka ED50 i ka hui L0 .5 ma mua o L0 (2.8 [2.6-3.0] mg / kg vs 2.4 [2.3-2.5] mg / kg; p1.0 a me L1.5 i emi iho ma mua o ka poʻe i loko o nā hui L0 a me L0.5 (p0.5 iʻoi aku ka nui ma mua o i loko o ka hui L0 (p0.5 i ʻoi aku ka nui ma mua o nā hui L0 a me L1.0 (pConclusion: I nā maʻi i loaʻa i ka aspiration uterine mua-trimester, intravenous lidocaine 1.0 mg / kg ma mua o ka propofol injection i hoʻemi nui i ka ED50 o propofol induction dose. ʻaʻohe hopena koʻikoʻi, e like me ka hopena o ka 1.5 mg / kg dose. Manaʻo mākou i ka 1.0 mg / kg e like me ka hopena maikaʻi loa. Ua hoʻopaʻa ʻia ka huina propofol, ka manawa ala, a me nā hanana ʻino.Nā hualoaʻa: Ua emi loa ka ED50 (95% confidence interval) o propofol i nā hui L1.0 a me L1.5 ma mua o ka hui L0 (1.6 [1.5-1.7] mg / kg a me 1.8 [1.6-1.9] mg / kg, me ka 2.4 [2.3-2.5] mg / kg, p1.0 a me L1.5 (p> 0.05) .5 ma mua o L0 (2.8 [2.6-3.0] mg / kg vs 2.4 [2.3-2.5] mg / kg; p1 .0 a me L1.5 i haʻahaʻa ma mua o ka poʻe i loko o nā hui L0 a me L0.5 (p0.5 iʻoi aku ka nui ma mua o ka hui L0 (p0.5 iʻoi aku ka nui ma mua o kēlā ma nā hui L0 a me L1.0 (pConclusion: I nā maʻi i loaʻa i ke kino). ʻO ka aspiration uterine mua-trimester, intravenous lidocaine 1.0 mg / kg ma mua o ka propofol injection i hoʻemi nui i ka ED50 o ka propofol induction dose me kaʻole o nā hopena koʻikoʻi, e like me ka hopena o ka 1.5 mg / kg.Ua hoʻopaʻa ʻia ka nui o nā dosis propofol, ka manawa ala, a me nā hanana ʻino.Nā hualoaʻa: Ua emi loa ka ED50 (95% confidence interval) o propofol i nā hui L1.0 a me L1.5 ma mua o ka hui L0 (1.6 [1.5-1, 7] mg / ml).кг и 1,8 [1,6–1,9] мг/кг по сравнению с 2,4 [2,3–2,5] мг/кг соответственно, p1,0 и L1,5 (p>0,05 ), однако, как ни удивительно, ED50 была значительно выше в группе L0. kg a me 1.8 [1.6-1.9] mg / kg me 2.4 [2.3-2.5] mg / kg, i kēlā me kēia, p1.0 a me L1.5 (p> 0.05), akā naʻe, he mea kupanaha, ua kiʻekiʻe loa ka ED50 i ka hui L0 .0.5 ma mua o L0 (2.8 [2.6-3.0] mg / kg vs. 2.4 [2.3-2.5] mg / kg; p1.0 a me L1.5 i emi iho ma mua o nā hui L0 a me L0.5 (p0.5 nui ma mua o nā hui. L0 a me L0.5) i loko o ka pūʻulu L0 (p0.5 i ʻoi aku ka nui ma mua o nā hui L0 a me L1.0 (pConclusion: i nā maʻi e loaʻa ana i ka ʻōpū aspiration i ka trimester mua, hoʻokele intravenous o lidocaine ma kahi ʻano o 1.0 mg / kg ma mua. ʻO ka injection of propofol i hoʻemi nui i ka ED50 o ka induction dose of propofol)) me kaʻole o nā hopena koʻikoʻi, e like me ka hopena o ka hopena o 1.5 mg / kg. Paipai mākou i ka 1.0 mg / kg e like me ka hopena maikaʻi loa. Nā hua'ōlelo: lidocaine, propofol , uterine aspiration, mean effective doseHoʻopaʻa ʻia ka nui o ka propofol dosis, ka manawa e ala ai, a me nā hanana ʻino.结果：L1.0 和L1.5 组异丙酚的ED50（95% 置信区间）显着低于L0 组（1.6 [1.5–1.7] mg/kg ， [1.5–1.7] mg. 2.4 [2.3–2.5] mg/kg；p1.0 和L1.5 (p> 0.05).然而，令人惊讶的是，L0 组的ED50 显着更高.5 比 [2.5] 比 [2.5] mg/kg vs 2.4 [2.3– 2.5] mg/kg；p1.0 和L1.5 低于L0 和L0.5 组(p0.5 大于L0 组（p0.5 大于L0 和L1.0 和管: In Ka 早期 早期 子 子 患者 患者 患者 I患者 患者 中 患者前, g g g前 酚 丙泊 剂量 剂量丙泊, g 1.5 mg 剂量的效果。我们推荐1.0 mg/kg结果： L1.0 和L1.5 组异丙酚的ED50（95% L0 mg/kg vs 2.4 [2.3– 2.5] mg/kg；p1.0 和L1.5 ： 在 接受 在 接受 在 接受 在 接受 在 接受 的ONT 中 酚 静脉 前 注射 注射 注射注射利多卡因 利多卡因注射 利多卡因注射利多卡因 利多卡因 1.0 mg / kg / kg 剂量 的 剂量 的 剂量 的 剂量 的 剂量 的 剂量 的 剂量 的 剂量 的 g 的 剂量 的 g 的 剂量 的 剂量 的 剂量 的 剂量 的 剂量 的 g 的效果。我们推荐1.0 mg / kgNā hualoaʻa: ʻO ka ED50 (95% confidence interval) o ka propofol ma nā hui L1.0 a me L1.5 he haʻahaʻa loa ia ma mua o ka hui L0 (1.6 [1.5-1.7] mg / kg a me 1.8 [1, 6-1.9] mg /kg).кг соответственно 2,4 [2,3–2,5] мг/кг, p1,0 и L1,5 (p>0,05). в группе L0 (2,8 [2,6–2,6–2,6]). kg, i kēlā me kēia, 2.4 [2.3-2.5] mg / kg, p1.0 a me L1.5 (p> 0.05).Eia naʻe, he mea kupanaha, uaʻoi aku ka kiʻekiʻe o ED50 i ka hui L0.5 ma mua o ka hui L0 (2.8 [2.6-2.6-2.6]).3.0] mg/kg vs. 2.4 [2.3-2.5] mg/kg;ʻO ka p1.0 a me ka L1.5 he haʻahaʻa ma mua o nā hui L0 a me L0.5 (p0.5 nui aʻe ma mua o nā hui L0 (p0.5 nui aʻe ma mua o L0 a me L1. 0 pūʻulu (p Nā hopena). : I nā maʻi wahine, I nā maʻi. i ka hoʻomaka ʻana o ka uterine aspiration mua trimester, intravenous lidocaine 1.0 mg / kg ma mua o ka propofol injection i hoʻemi nui i ka ED50 o ka propofol induction dose me ka ʻole o nā hopena koʻikoʻi, e like me ka 1.5 mg / kg dose Manaʻo mākou i ka 1.0 mg / kg kg i ka hopena maikaʻi loa Keywords: lidocaine, propofol, uterine aspiration, mean effective dose
No ka mea he ʻoi aku ka pōkole o ka hapalua o ke ola o propofol ma mua o nā lāʻau lapaʻau ʻē aʻe, hoʻohana mau ʻia ka propofol ma ke ʻano he anesthetic intravenous e hāʻawi i ka hoʻomaha i ka wā o nā hana maʻi ma waho.1,2 Eia naʻe, pili ka sedation me nā kiʻekiʻe kiʻekiʻe o propofol me nā hopena ʻaoʻao hanu a me ke kahe.Hoʻonui ka nui o ka propofol i ka pilikia o ka apnea, hāʻule ke ala o luna, a me ka hypotension;3-7 aʻo nā haʻahaʻa haʻahaʻa e hopena i ka sedation kūpono ʻole.ʻO ka propofol i hui pū me nā lāʻau ʻē aʻe e hōʻemi i ka pilikia o ka hanu a me nā pilikia circulatory a hāʻawi i kahi hopena sedative palekana a ʻoluʻolu.No laila, pono kahi adjuvant maikaʻi e hōʻemi i ka pane ʻana i ka ʻokiʻoki a hoʻemi i ka pono o propofol.I nā makahiki i hala iho nei, ua hoʻohana ʻia ka midazolam a me ka dexmedetomidine i ke kaʻina outpatient, akā lōʻihi ka hapalua o ke ola o ka midazolam, ua lohi ka induction o ka dexmedetomidine, a he nui ka lāʻau, no laila ua kaupalena ka hoʻohana.8.9
ʻO ka lidocaine he mea hoʻohana maʻamau ka lāʻau lapaʻau kūloko i ka hana lapaʻau.10 Ua ʻike ʻia nā noiʻi mua e hiki i ka lidocaine intravenous ke hoʻoikaika i ka hopena sedative o ka anesthesia e pili ana i propofol.11-15 ʻO nā pono perioperative ʻē aʻe o ka lidocaine intravenous e hoʻopau i ka ʻeha o ka propofol injection, hoʻemi i ka pono o ka opioid, ka hoʻihoʻi ʻana i ka hana o ka ʻōpū ma hope o ka ʻoki ʻana, a me ka emi ʻana o ka ʻeha ma hope o ka hana ʻana. /mL).20,21 Foo et al i paipai ʻia i loko o kā lākou mau ʻōlelo aʻoaʻo i hoʻopuka hou ʻia inā hoʻohana ʻia ka lidocaine intravenous, ʻaʻole i ʻoi aku ka nui o ka nui ma mua o 1.5 mg/kg me ka hoʻohana ʻana i ke kaumaha kino kūpono o ka mea maʻi.21 Ua palekana kahi haʻawina a Lili et al ua hōʻike mua i ka hoʻohana ʻana i ka bolus intravenous lidocaine 1.5 mg / kg ma mua o ka hoʻokomo ʻana i ka anesthesia i hopena i ka 36% hoʻemi i ka ED50 o propofo Лидокаин является широко используемым местным анестетиком в клинической практике.Предыдущие исследования показали, что внутривенное введение лидокаина может усиливать седативный эффект анестезипользование.ускоренное восстановление функции желудочно-кишечного тракта после операции и снижение частоты послеоперационной хронической боли.16–19 Внутривенный лидокаин имеет короткий период полувыведения (90–120 мин), а его концентрация в крови, зарегистрированная в клинических исследованиях, оставалась ниже токсической концентрации (> 5 мкг)./мл)20,21 Foo et al.в своих недавно опубликованных согласованных рекомендациях рекомендовали, чтобы при внутривенном введении лидокаина начальная доза не более 1,5 мг/кг, рассчитанная с использованием идеальной массы тела пациента, была безопасной.21 Исследование Lili и др.уже доказали, что болюсное внутривенное введение лидокаина в дозе 1,5 мг/кг перед индукцией андукцией андукцией андукцией андукцией андукцией анестезино привиделение 3000 %.利多卡 因因 k中 使用 _aloha 使用 局部 局部麻醉剂 研究麻醉剂, 研究 发现 静脉 作用作用 的 镇静镇静: 静脉 围 注射利多卡因 期益处. 其他 手术作用 的 期益处镇静: 其他 围注射利多卡因 的 镇静作用: 其他 围注射利多卡因 的 镇静作用: 其他 围注射利多卡因 的 镇静作用: 其他 围 注射利多卡因 期益处.包括 减轻 减轻 减少 疼痛, 减少 需求, 术后 需求, 术后 降低 降低 降低 降低 因 半衰期 短半衰期: 临床 研究 报告因 分钟), 临床 研究 报告因 分钟), 临床 研究 报告因 分钟). Kapaʻo kumuhkah 的 其 μ 毒性 μ低于毒性毒性毒性毒性毒性毒性毒性毒性毒性g /moku / 在 人 人 人, 计算 计算 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不 的 初始剂量 不超过 1.5 mg/kg 是安全的。21 Lili 的一项研究等人已经证明，在麻醉诱导前静脉推注利天 5 mg 一项研究等人已经证明，在麻醉诱导前静脉推注利利多 住所 5 mg 你多利利多卡 因 临床 实践 中 广泛 使用 的 局部 麻醉剂。 10 先前 研究 发现 ， 静脉 注射利多卡 因 可以 增强 基于 酚 的 麻醉 镇静 作用。 11-15 静脉 的 其他 手术 期益处 期益处 期益处 期益处 期益处包括 减轻注射注射, 减少 需求需求 需求需求, 术 后 恢复恢复, 发生率 因降低 短) 研究), 研究 血液) 研究)毒性 浓度 （(> 5 мкг /мл).20,21 foo 等 在 他们 新 发表 的 识 指南 中 建议 ， 使用 静脉 注射利多卡因 使用 患者 体重 计算 的 初始剂量 不 如果 静脉 ， 患者 理想 计算 的 不 不 不乐 He 理想计算 的 不 不 1,5 5 к安全 a by Kauwaiwai 一 证明证明 利多卡因推注 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 1,8гNA 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 1,8гNA 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因 利多卡因利多卡因 利多卡因 推注 利多卡因 1,8 5 诱导利多卡因 利多卡因 利多卡因 利多卡因 n .- /кг 可 丙泊 酚 的 ed50 降低 36%l 用 于 减轻 宫腔镜 宫腔镜 宫腔镜 扩张 的 反应 ... 还 证明 成注射, 而 检查 期间期间, 而 检查 检查期间而 而 而 而 而 而 患者 检查 异丙酚 诱导剂量 的 的 ， ， ，不会显着影响血和.
No laila, ua manaʻo kēia noiʻi e hoʻāʻo i ka hopena o nā ʻokoʻa like ʻole o ka lidocaine intravenous ma ka ED50 a me ED95 o ka propofol-inducing doses i ka wā mua o ka trimester uterine aspiration, a me ka hoʻoholo ʻana i ka hopena maikaʻi loa, i ko mākou ʻike, ʻaʻole i aʻo ʻia. i nā haʻawina mua..
Ma hope o ka hoʻopau ʻana i ka hoʻolālā ʻana o kēia hoʻokolohua lapaʻau, ua hoʻokuʻu mākou i ka loiloi loiloi mua o ka West China Second Hospital, a ʻo ka mea e hiki mai ana he mau mahina i hala.No laila, ua ʻimi mākou i ka loiloi etika mai ka China Clinical Trials Registration Ethics Committee, he komite kūʻokoʻa kūʻokoʻa i hoʻonohonoho ʻia e ka China Clinical Trials Registration Center.Ua ʻae ʻia kēia protocol study e ke Kōmike Ethics o ka Chinese Clinical Trials Registry (ChiECRCT20210401) a ua hoʻopaʻa inoa ʻia me ka Chinese Clinical Trials Registry (ChiCTR2100049263).Ua mālama ʻia ke aʻo ʻana e like me ka Hōʻike o Helsinki mai Kepakemapa 2021 a Mei 2022, a ua loaʻa iā mākou ka ʻae ʻike i kākau ʻia mai 100 mau mea noiʻi ma mua o ka hoʻomaka ʻana o ke aʻo ʻana.
Ua mālama ʻia kēia noiʻi ʻana i nā maʻi wahine i hoʻonohonoho ʻia e hana i ka hysteroscopy outpatient trimester mua ma lalo o ka anesthesia maʻamau ma ke Kulanui ʻo Sichuan West China Second Hospital.Ua komo ka haʻawina i nā poʻe maʻi me ke kūlana kino ASA I a i ʻole II, nā makahiki 18-50 a hoʻokē ʻai no nā hola 6 (solids) a me 2 mau hola (wai) ma mua o ka hana ʻana. ʻO nā pae hoʻohālikelike e like me kēia: nā maʻi me ka helu kino kino (BMI)> 28 kg / m2 a i ʻole BMI <18 kg / m2; ʻO nā pae hoʻohālikelike e like me kēia: nā maʻi me ka helu kino kino (BMI)> 28 kg / m2 a i ʻole BMI <18 kg / m2; Критерии исключения были следующими: пациенты с индексом массы тела (ИМТ) >28 кг/м2 или ИМТ <18; ʻO nā pae hoʻohālikelike e like me kēia: nā maʻi me ka helu kino kino (BMI)> 28 kg / m2 a i ʻole BMI <18 kg / m2;排除标准如下：体重指数（BMI）>28 kg/m2或BMI<18 kg/m2的患者；排除标准如下：体重指数（BMI）>28 kg/m2或BMI<18 kg/m2的患者； Критерии исключения: пациенты с индексом массы тела (ИМТ) > 28 кг/м2 или ИМТ < 18 кг/м2; Nā pae hoʻokaʻawale: nā maʻi me ka helu kino kino (BMI)> 28 kg / m2 a iʻole BMI <18 kg / m2; nā maʻi me ke kaumaha o ke kino <40 kg; nā maʻi me ke kaumaha o ke kino <40 kg; пациенты с массой тела <40 кг; nā poʻe maʻi i ke kaumaha <40 kg;体重<40公斤的患者；体重<40公斤的患者； Пациенты с массой тела < 40 кг; ʻO nā maʻi e kaumaha ana <40 kg;ʻO nā maʻi me ka hānau ʻana o ka wahine a me ka mōʻaukala o ka cervical dilatation i loko o 6 mau mahina;nā maʻi maʻi i nā anesthetics kūloko, propofol, fentanyl, a i ʻole nā ​​​​lāʻau lapaʻau ʻē aʻe e pili ana i kēia haʻawina;nā mea maʻi me ka maʻi hepatic a me ka renal insufficiency, nā maʻi endocrine, nā maʻi me nā maʻi metabolic, nā maʻi cardiovascular, nā maʻi o ka ʻōnaehana hanu a i ʻole nā ​​​​maʻi o ke kikowaena o ke kikowaena ʻo ka hoʻohana lōʻihi ʻana i nā sedatives, analgesics, nā lāʻau lapaʻau e hiki ke hoʻopilikia i ka metabolism o nā anesthetics kūloko a i ʻole. nā maʻi i nā lā 7 Ua ʻae ʻia nā hoʻokolohua ʻē aʻe i loko o 3 mau mahina ma mua o ke aʻo ʻana Nā lāʻau lapaʻau a i ʻole nā ​​​​mea maʻi i komo i nā hoʻokolohua lapaʻau ʻē aʻe;nā maʻi i hoʻohui i ka waiʻona a i ʻole nā ​​​​lāʻau leʻaleʻa;nā mea maʻi me nā helu Mallampti III-IV.Ua hoʻomaopopo ʻia nā mea komo a pau e pili ana i ke kumu o ka haʻawina.
ʻO ka pōkole, ua hoʻokaʻawaleʻia nā maʻi 100 i nā hui L0, L0.5, L1.0, a me L1.5 e like me ke kaʻina hana maʻamau i hanaʻia e ka lolouila me ka nui o ka'āpana 4. Ua hoʻopaʻaʻia ka helu kūikawā i loko o kahi enveloppi opaque.ʻO ka poʻe Anesthesiologists e hoʻomākaukau a lawelawe i nā lāʻau i ʻike i nā hana hui.ʻO nā mea noiʻi, nā mea maʻi, nā kauā, a me nā kahu hānai nāna i hōʻiliʻili i ka ʻikepili he makapō hana.
ʻAʻole i hāʻawi ʻia nā lāʻau ʻē aʻe ma mua o ka hoʻokomo ʻana i ka anesthesia.Hoʻokomo ʻia kahi cannula 22 gauge i loko o ka vein a ua hoʻomaka ʻia ka infusion lactate Ringer (2 ml/kg/h).I ke komo ʻana i loko o ka lumi hana, ua hāʻawi ʻia ka mea maʻi i ka inhalation o ka oxygen ma o ka mask ma ka wikiwiki o 10 L / min no 3 mau minuke ma mua o ka hoʻokomo ʻana, a nānā ʻia ke kahe koko invasive, electrocardiogram, ka hanu hanu, a me ka peripheral capillary oxygen saturation (SpO2) i nānā ʻia. a hiki i ka wā i hoʻokuʻu ʻia ai ka mea maʻi.mai anesthesia.a ua hoʻoili ʻia i ka wā postoperative i ka ʻoihana anesthesia.Hoʻopaʻa ʻia ʻo SpO2, ka puʻuwai puʻuwai (HR) a me ke kahe koko invasive i ʻekolu mau manawa: i ka manawa o ka hoʻomākaukau ʻana no ka induction o ka anesthesia (T0), i ka hopena o ka induction o ka anesthesia (T1), i ka hopena o ka dilatation cervical. (T2).Ua hoʻomākaukauʻia nā mea hoʻomākaukau a pau i ka mahana wela.mahana, mālama a hoʻohana koke ʻia.Lidocaine (Sinopharm Rongsheng Pharmaceutical Co., Ltd.) 0.5 mg / kg, 1.0 mg / kg a me 1.5 mg / kg ua hoʻoheheʻeʻia i ka 10 ml me ka paʻakai i loko o ka 10 ml syringe.E hoʻomākaukau hoʻi i ka nui like o ka saline i loko o kahi syringe 10 ml.Ua hoʻomaka ʻia ka hoʻomaka ʻana i ka anesthesia me kahi bolus injection o fentanyl 1.0 μg / kg (Yichang Renfu Pharmaceutical Co., Ltd., Kina).I hoʻokahi minuke ma hope, ua hoʻomākaukau ʻia ka lidocaine a i ʻole ka saline e like me ka mea i kuhikuhi ʻia no kahi o 30 kekona, a laila hāʻawi ʻia ka propofol (Corden Pharma SPA, Italia) i nā maʻi āpau ma ka wikiwiki o 0.4 ml/s.ʻO ka mea maʻi mua i kēlā me kēia hui i loaʻa iā propofol 2.0 mg / kg.I nā maʻi ma hope, ua hoʻonui a hoʻemi ʻia ka nui o ka propofol e 0.2 mg / kg, ma muli o ka pane o ka mea maʻi ma mua.Ua hoʻohana ʻia ka Modified Observer Alertness/Sedation Rating Scale (MOAA/S) no ka nānā ʻana i ka hohonu o ka hoʻomaha.24 ʻO ka pālākiō MOAA/S he pālākiō 6 a ua wehewehe ʻia ʻo 5: he inoa maʻalahi ke haʻi ʻia ma kahi leo maʻamau;4: pane moe i kahi inoa i haʻi ʻia ma kahi leo maʻamau;3: me ka leo nui a/a i ʻole ka pane hou ʻana ma hope o ke kāhea ʻana i kahi inoa;2: pane wale i ka hoʻoulu ʻoluʻolu a haʻalulu paha;1: pane wale i ka ʻeha ʻeha o ka ʻiʻo trapezius;0: ʻaʻohe pane i ka ʻoki ʻana o ka ʻiʻo trapezius. Ma hope o ka helu ʻana o ka MOAA/S he <1, ua ʻae ʻia ke kauka e hoʻomaka i ke kau ʻana i ka speculum vaginal, kahi i hōʻailona ai i ka hoʻomaka ʻana o ka hana. Ma hope o ka helu ʻana o ka MOAA/S he <1, ua ʻae ʻia ke kauka e hoʻomaka i ke kau ʻana i ka speculum vaginal, kahi i hōʻailona ai i ka hoʻomaka ʻana o ka hana. После того, как оценка MOAA/S была <1, хирургу было разрешено начать установку вагинального зеркала, что сигнализироц. I ka manawa o ka helu MOAA/S <1, ua ʻae ʻia ke kauā e hoʻomaka e hoʻokomo i ka speculum vaginal, e hōʻailona ana i ka hoʻomaka ʻana o ka hana.在MOAA/S 评分<1 后，外科医生被允许开始放置阴道窥器，这标志着手术的开始。在 MOAA/S После того, как оценка MOAA/S <1, хирургу было разрешено начать установку вагинального зеркала, что ознаменчовало нароц. I ka manawa o ka helu MOAA/S <1, ua ʻae ʻia ke kauka e hoʻomaka e hoʻokomo i ka speculum vaginal, e hōʻailona ana i ka hoʻomaka ʻana o ke kaʻina hana.Hana ʻia nā hana a pau e ke kauka lapaʻau hoʻokahi.Ua manaʻo ʻia ka hopena inā he ≥1 ʻo MOAA / S ma hope o ke kau mua o ka propofol a i ʻole inā ʻike ʻia ka neʻe ʻana o nā lālā mai ka hoʻomaka ʻana a hiki i ka dilatation cervical;a i ʻole, ua manaʻo nui ʻia ka hopena.I nā hihia kūpono ʻole, ua hoʻonui ʻia ka nui o ka propofol e 0.2 mg / kg i nā maʻi ma hope.Ua ho'ēmiʻia ka propofol e 0.2 mg / kg i nā maʻi ma hope no nā hihia kūpono.Inā he ≥1 ka MOAA/S a i ʻole ke ʻano o ka neʻe ʻana o nā lālā i ka wā o ke kaʻina, hāʻawi ʻia ka propofol 0.5-1.0 mg/kg e like me ka pono o ke kino.Ma hope o ka hoʻokomo ʻana i ka anesthesia, inā ʻoi aku ka manawa o ka apnea ma mua o 1 min, ua wehewehe ʻia ʻo ke kaumaha o ka hanu a ua hana ʻia ka ventila mechanical a hiki i ka hoʻihoʻi ʻana o ka hanu manawaleʻa.Inā ʻike ʻia ke ala ala ea o luna, e hoʻokiʻekiʻe i ka iwi ā lalo e ʻae i ka ea. Inā ʻo SpO2 <92%, ua wehewehe ʻia ka hypoxia a ua hoʻopau ʻia ke kaʻina hana, a ua hoʻohana ʻia kahi hoʻoheheʻe pale maka i kōkua ʻia e hoʻomaʻamaʻa i ka saturation oxygen. Inā ʻo SpO2 <92%, ua wehewehe ʻia ka hypoxia a ua hoʻopau ʻia ke kaʻina hana, a ua hoʻohana ʻia kahi hoʻoheheʻe pale maka i kōkua ʻia e hoʻomaʻamaʻa i ka saturation oxygen. При SpO2 <92% определяли гипоксию и процедуру прекращали, а для нормализации сатурации кислородом процедуру прекращали, а для нормализации сатурации кислородом применол прекращали . Ma SpO2 <92%, ua hoʻoholo ʻia ka hypoxia a ua hoʻopau ʻia ke kaʻina hana, a ua hoʻohana ʻia kahi hoʻoheheʻe ʻana i ka pale maka kōkua e hoʻomaʻamaʻa i ka saturation oxygen.如果SpO2 < 92%，则定义为缺氧并停止手术，并应用辅助面罩通气以使氧饱和度有。如果SpO2 < 92%，则定义为缺氧并停止手术，并应用辅助面罩通气以使氧饱和度有。 Если SpO2 < 92%, определите гипоксию и прекратите операцию, а также примените искусственную вентиляцию Inā ʻo SpO2 <92%, e hoʻoholo i ka hypoxia a hoʻopau i ke kaʻina hana, a e hoʻoheheʻe me ka mask e hoʻomaʻamaʻa i ka saturation oxygen. Inā ʻoi aku ka HR ma lalo o 50 beats / min, ua hāʻawi ʻia ka atropine 0.5 mg. Inā ʻoi aku ka HR ma lalo o 50 beats / min, ua hāʻawi ʻia ka atropine 0.5 mg. Если ЧСС <50 уд/мин, вводили атропин 0,5 мг. Inā ʻoi aku ka nui o ka puʻuwai <50 bpm, ua hāʻawi ʻia ka atropine 0.5 mg.如果HR <50 次/分钟，则给予阿托品0.5 mg。如果HR<50次/分钟，则给予阿托品0.5 mg。 Если ЧСС <50 уд/мин, введите 0,5 мг атропина. Inā ʻoi aku ka wikiwiki o ka naʻau ma lalo o 50 bpm, e hāʻawi i ka 0.5 mg atropine. Ua wehewehe ʻia ʻo Hypotension e like me SBP, diastolic blood pressure (DBP), a i ʻole mean arterial pressure (MAP) i hoʻemi ʻia ma mua o 20% o ka baseline, a i ʻole SBP<80 mmHg. Ua wehewehe ʻia ʻo Hypotension e like me SBP, diastolic blood pressure (DBP), a i ʻole mean arterial pressure (MAP) i hoʻemi ʻia ma mua o 20% o ka baseline, a i ʻole SBP<80 mmHg. Гловни Offickeия Ua wehewehe ʻia ʻo Hypotension ma ke ʻano he emi ʻana o ka SBP, ke koko diastolic (DBP), a i ʻole mean arterial pressure (MAP) e ʻoi aku ma mua o 20% o ka baseline, a i ʻole SBP <80 mmHg.低血压定义为SBP、舒张压(DBP) 或平均动脉压(MAP) 下降超过基线的20%，或SBP<80 mmHg。 20%, ka SBP<80 mmHg. Гдепнзи м оплили товнагоамное ар арнасто авля авлия Ua wehewehe ʻia ʻo Hypotension ma ke ʻano he emi ʻana o ka ʻoi aku ma mua o 20% mai ka baseline ma SBP, diastolic blood pressure (DBP), a i ʻole mean arterial pressure (MAP), a i ʻole SBP <80 mmHg.Inā hiki mai ka hypotension, 0.2-0.4 mg o ka metahydroxylamine a i ʻole 5-10 mg o ka ephedrine e lawelawe ʻia, ma muli o ke kūlana.Hoʻopaʻa ʻia ka nui o ka propofol dose, ka manawa o ka hana, a me ka manawa hoʻihoʻi i ka hopena o ka hana.Ua hōʻike pū ʻia ka Myoclonus a me nā hopena ʻaoʻao o ka anesthetics kūloko, e like me ka tinnitus, perioral numbness, a me ka palpitations ma hope o propofol.
ʻO nā mea hope mua ka ED50 a me ED95 o ka propofol induction dose.ʻO nā helu hope ʻelua, ʻo ia ka nui o ka nui o ka propofol, ka manawa hoʻihoʻi ma hope o ka hana, ke kaumaha o ka hanu, ke keakea o ke ea o luna, ka hypoxia, bradycardia, hypotension, a me postpropofol myoclonus.
ʻO ke kūʻokoʻa a me ka puʻunaue ʻike ʻole o ka ʻikepili i aʻo ʻia ma ke ʻano kaʻina o luna-lalo he mea paʻakikī ke kūkulu ʻana i nā lula theoretically rigorous no ka helu ʻana i ka nui o ka laʻana.25 Ua hoʻoholo ʻia ka nui o ka laʻana e ka lula hoʻomaha.Pono e hoʻopaʻa inoa ʻia nā maʻi ma mua o ka hoʻololi ʻia ʻana o nā hopena kūpono ʻole i nā hopena kūpono.Ua hōʻike ʻia nā haʻawina simulation, i ka hapanui o nā hihia, hiki i ka hoʻokomo ʻana o nā mea maʻi ma lalo o 20-40 hiki ke hāʻawi i kahi kuhi paʻa o ka nui o ka hopena.ʻO nā hoʻāʻo anesthesia ʻē aʻe e hoʻohana ana i kēia ala e pili pū ana i nā maʻi 20-40.26,27 I kā mākou aʻoʻana, ua hoʻokomoʻia kēlā me kēia hui i nā maʻi 25, i lawa no kaʻikepili helu.
Ua hoʻohana ʻia ʻo SPSS 26.0 (IBM Inc., Armonk, NY, USA) e nānā i nā hopena.Ua hoʻohana ʻia ka hoʻāʻo ʻo Shapiro-Wilk e hoʻoholo i ka puʻunaue maʻamau o ka ʻikepili.Ua hōʻike ʻia nā ʻano hoʻololi maʻamau maʻamau ma ke ʻano he mean ± ka hoʻohālikelike maʻamau a hoʻohālikelike ʻia ma waena o nā hui me ka hoʻohana ʻana i ka ANOVA ala hoʻokahi.Ua hōʻike ʻia nā ʻikepili i puʻunaue like ʻole ʻia ma ke ʻano he median (interquartile range) a hoʻohālikelike ʻia me ka hoʻohana ʻana i ka hōʻike helu helu Wilcoxon.Hōʻike ʻia ka ʻikepili helu ma ke ʻano he n (%) a nānā ʻia me ka hoʻohana ʻana i ka hoʻāʻo chi-square.Ua helu ʻia ka ED50 (95% CI) no ka propofol ma ke ʻano he mean o ka waena waena o ka crossover koʻikoʻi me ka hoʻohana ʻana i ka ANOVA ala hoʻokahi me ke ʻano o Bonferroni no ka hoʻohālikelike ʻana ma waena o nā hui.Ua manaʻo ʻia ʻo ED95 (95% CI) me ka hoʻohana ʻana i ka regression probabilistic. No nā kānana a pau, ua manaʻo ʻia ka p<0.05 e hōʻike i nā ʻokoʻa koʻikoʻi. No nā kānana a pau, ua manaʻo ʻia ka p<0.05 e hōʻike i nā ʻokoʻa koʻikoʻi. Для всех анализов считалось, что p<0,05 указывает на статистически значимые различия. No nā kānana a pau, ua manaʻo ʻia ka p<0.05 e hōʻike i kahi ʻokoʻa koʻikoʻi.对于所有分析，p<0.05 被认为表明有统计学意义的差异。 p<0.05 被认为表明有统计学意义的差异。 Для всех анализов считалось, что p<0,05 указывает на статистически значимое различие. No nā kānana a pau, ua manaʻo ʻia ka p<0.05 e hōʻike i kahi ʻokoʻa koʻikoʻi.
He 121 mau maʻi i hoʻopaʻa inoa ʻia a nānā ʻia.ʻO kēia mau mea, ua hoʻopiliʻia nā maʻi 100 i nā hui 4 a hoʻokomoʻia i loko o ka hōʻike hope loa (Figure 1).ʻO nā hiʻohiʻona kumu o nā huiʻehā o nā maʻi, e like me ka makahiki, BMI, ka puʻuwai puʻuwai (T0), SBP (T0), DBP (T0) a me SBP (T0),ʻaʻole iʻokoʻa loa (Table 1).
Hōʻike ʻia kahi papa luna-lalo e hōʻike ana i ka nui a me ka pane o ka mea maʻi ma lalo nei (Figure 2).ʻO ka mean propofol infusion doses ma nā hui L0, L0.5, L1.0, a me L1.5 he 2.3 ± 0.2, 2.7 ± 0.3, 1.6 ± 0.2, a me 1.7 ± 0.2 mg/kg, kēlā me kēia.Ma ka fig.Hōʻike ka 3 i kahi loiloi o ka pane ʻana o ka lidocaine a me propofol i nā hui maʻi ʻehā.Hōʻike ka papa 2 i ka ED50 a me ED95 (95% CI) o propofol no nā lima ʻehā, e pili ana i ka Dixon-Massey ordinal up-down order a me probability regression, kēlā me kēia. ʻO ka ED50 o propofol ma nā hui L1.0 a me L1.5 he emi loa ia ma mua o ka hui L0 (1.6 [1.5-1.7] mg / kg; 1.8 [1.6-1.9] mg / kg vs 2.4 [2.3-2.5] mg / kg, p<0.001). ʻO ka ED50 o propofol ma nā hui L1.0 a me L1.5 he emi loa ia ma mua o ka hui L0 (1.6 [1.5-1.7] mg / kg; 1.8 [1.6-1.9] mg / kg vs 2.4 [2.3-2.5] mg / kg, p<0.001).ʻO ka ED50 o propofol ma nā hui L1.0 a me L1.5 he haʻahaʻa loa ia ma mua o ka hui L0 (1.6 [1.5-1.7] mg / kg; 1.8 [1.6-1.9] mg / kg).kg me 2.4 [2.3–2.5] mg/kg).кг кг, р<0,001). kg kg, p<0.001). L1.0 和L1.5 组异丙酚的ED50 显着低于L0 组（1.6 [1.5–1.7] mg/kg；1.8 [1.6–1.9] mg/kg vs 2.4 [2.3–2.5] mg/kg ，p <0.001）. L0 ，p < 0.001）.Ua emi loa ka propofol ED50 ma nā hui L1.0 a me L1.5 ma mua o ka hui L0 (1.6 [1.5-1.7] mg / kg; 1.8 [1.6-1.9] mg / kg).kg me 2.4 [2.3–2.5] mg/kg)./кг кг, p < 0,001). / kg kg, p < 0.001). Ua kiʻekiʻe ka waiwai o ED50 i ka hui L0.5 ma mua o ka hui L0 (2.8 [2.6-3.0] mg / kg vs 2.4 [2.3-2.5] mg / kg, p <0.05). Ua kiʻekiʻe ka waiwai o ED50 i ka hui L0.5 ma mua o ka hui L0 (2.8 [2.6-3.0] mg / kg vs 2.4 [2.3-2.5] mg / kg, p <0.05). Величина ED50 была выше в группе L0,5, чем в группе L0 (2,8 [2,6–3,0] мг/кг против 2,4 [2,3–2,5] мг/кг, p<0 ,05). Ua kiʻekiʻe ka ED50 ma ka hui L0.5 ma mua o ka hui L0 (2.8 [2.6-3.0] mg / kg vs. 2.4 [2.3-2.5] mg / kg, p <0.05). L0.5 组的ED50 值高于L0 组（2.8 [2.6-3.0] mg/kg vs 2.4 [2.3-2.5] mg/kg，p<0.05）。 L0.5 组的ED50 值高于L0 组（2.8 [2.6-3.0] mg/kg vs 2.4 [2.3-2.5] mg/kg，p<0.05）。 Группа L0,5 имела более высокие значения ED50, чем группа L0 (2,8 [2,6–3,0] мг/кг против 2,4 [2,3–2,5] p<0,5] мг/ 05). Loaʻa i ka hui L0.5 nā waiwai ED50 kiʻekiʻe ma mua o ka hui L0 (2.8 [2.6-3.0] mg / kg vs. 2.4 [2.3-2.5] mg / kg, p<0, 05). ʻAʻohe ʻokoʻa nui ma ED50 o propofol ma waena o nā hui L1.0 a me L1.5 (p>0.05). ʻAʻohe ʻokoʻa nui ma ED50 o propofol ma waena o nā hui L1.0 a me L1.5 (p>0.05). Не было существенной разницы ma ED50 пропофола между группами L1.0 и L1.5 (p>0,05). ʻAʻohe ʻokoʻa nui o propofol ED50 ma waena o nā hui L1.0 a me L1.5 (p>0.05). L1.0组和L1.5组异丙酚的ED50差异无统计学意义（p>0.05）。 L1.0组和L1.5组异丙酚的ED50差异无统计学意义（p>0.05）。 Не было существенной разницы ma ED50 пропофола между группой L1.0 и группой L1.5 (p>0,05). ʻAʻohe mea nui i ka propofol ED50 ma waena o ka hui L1.0 a me ka hui L1.5 (p> 0.05).
Papa 2 ED50 a me ED95 (95% CI) o nā pūʻulu propofol ʻehā e pili ana i ka hoʻoili ʻana o Dixon-Massey ma luna a me lalo a me ka regression Probit.
Kiʻi 2 ʻO Dixon ma luna a me lalo o nā hui ʻehā.“●” ʻo ia ka manaʻo, “○” ʻo ia ka manaʻo ʻole.
ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā hui i ka lōʻihi o ke kaʻina hana a me ka manawa ala e like me ka mea i helu ʻia ma ka Papa 3 (p> 0.05). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā hui i ka lōʻihi o ke kaʻina hana a me ka manawa ala e like me ka mea i helu ʻia ma ka Papa 3 (p> 0.05). Не было никаких существенных различий между группами в продолжительности операции и времени пробуждения, коления, 0ности операции и времени пробуждения. ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā hui i ka lōʻihi o ka hana a me ka manawa o ke ala ʻana, e like me ka mea i hōʻike ʻia ma ka papa 3 (p> 0.05).各组手术时间和苏醒时间差异无统计学意义（p>0.05），见表3。 p>0.05），见表3. Не было существенной разницы во времени работы и времени пробуждения между группами (p>0,05), как показано ma 3. ʻAʻohe ʻokoʻa koʻikoʻi o ka manawa hana a me ka manawa ala ma waena o nā hui (p>0.05), e like me ka hōʻike ʻana ma ka Papa 3. ʻO ka nui o ka nui o ka propofol i koi ʻia no ke kaʻina holoʻokoʻa i ʻoi aku ka nui o nā hui L0 a me L0.5 ma mua o nā hui ʻelua ʻē aʻe (p<0.05, Papa 3). ʻO ka nui o ka nui o ka propofol i koi ʻia no ke kaʻina holoʻokoʻa i ʻoi aku ka nui o nā hui L0 a me L0.5 ma mua o nā hui ʻelua ʻē aʻe (p<0.05, Papa 3). Средние дозы общего пропофола, необходимые для всей операции, были значительно выше в группах L0 и L0,5, для всей операции, были значительно выше в группах L0 и L0,5, друха люблют (группах) ʻO ka nui o ka nui o ka propofol i koi ʻia no ka hana holoʻokoʻa i ʻoi aku ka kiʻekiʻe ma nā hui L0 a me L0.5 ma mua o nā hui ʻelua ʻē aʻe (p<0.05, Papa 3).整个手术所需的总丙泊酚平均剂量在L0 和L0.5 组显着高于其他两组（p<0.05）。整个手术所需的总丙泊酚平均剂量在L0和L0.5 Средняя доза общего пропофола, необходимая для всей процедуры, была значиптельно выше в группах L0 и L0,5, ха ч L0,5, ха ч L0,5, хал. ʻO ka nui o ka nui o ka propofol i koiʻia no ke kaʻina hana holoʻokoʻa iʻoi aku ka kiʻekiʻe ma nā hui L0 a me L0.5 ma mua o nā huiʻelua'ē aʻe (p<0.05, Papa 3). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā pūʻulu i ka hiki ʻana mai o ke ala ea o luna (p>0.05). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā pūʻulu i ka hiki ʻana mai o ke ala ea o luna (p>0.05). Существенных различий между группами по частоте возникновения обструкции верхних дыхательных путей не было (p>0,0ло). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā pūʻulu i ka hopena o ke ala ea o luna (p>0.05).上气道阻塞发生率组间差异无统计学意义（p>0.05）。上气道阻塞发生率组间差异无统计学意义（p>0.05）。 Достоверной разницы в частоте обструкции верхних дыхательных путей между группами не было (p>0,05). ʻAʻohe ʻokoʻa koʻikoʻi o ka loaʻa ʻana o ke ala ākea o luna ma waena o nā hui (p>0.05). ʻOi aku ka nui o ke kaumaha o ka hanu ma ka hui L0.5 ma mua o nā hui L0 a me L1.0 (p<0.05). ʻOi aku ka nui o ke kaumaha o ka hanu ma ka hui L0.5 ma mua o nā hui L0 a me L1.0 (p<0.05). Частота угнетения дыхания в группе L0,5 была выше, чем в группах L0 и L1,0 (p<0,05). ʻO ke alapine o ka hanu hanu ma ka hui L0.5 ua kiʻekiʻe ma mua o nā hui L0 a me L1.0 (p <0.05). L0.5组呼吸抑制发生率高于L0、L1.0组（p<0.05）。 L0.5组呼吸抑制发生率高于L0、L1.0组（p<0.05）。 Частота угнетения дыхания в группе L0,5 была выше, чем в группах L0 и L1,0 (p<0,05). ʻO ke alapine o ka hanu hanu ma ka hui L0.5 ua kiʻekiʻe ma mua o nā hui L0 a me L1.0 (p <0.05). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā pūʻulu i ka hanana ʻana o ka hypotension (p> 0.05), akā ʻo ka emi ʻana o ka SBP ma hope o ka hoʻokomo ʻana i ka anesthesia ma ka hui L0.5 ʻoi aku ka nui ma mua o ka hui L0 (p<0.01). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā pūʻulu i ka hanana ʻana o ka hypotension (p> 0.05), akā ʻo ka emi ʻana o ka SBP ma hope o ka hoʻokomo ʻana i ka anesthesia ma ka hui L0.5 ʻoi aku ka nui ma mua o ka hui L0 (p<0.01). Достовер Празовй Герлииловиа сне саупленлоепле ʻAʻoheʻokoʻa nui ma waena o nā hui i ka hopena o ka hypotension (p> 0.05), akāʻo ka emiʻana o ka SBP ma hope o ka hoʻokomoʻana i ka anesthesia iʻoi aku ka nui ma ka hui L0.5 ma mua o ka hui L0 (p <0.01).低血压发生率组间差异无统计学意义（p>0.05），但L0.5组麻醉诱导后SBP下陎幧.0下陎幧.低血压发生率组间差异无统计学意义（p>0.05），但L0.5组麻醉诱导后SBP下陎幧.0下降幧. Ине скинно mp3 Галь мерумбыли гремупем мембера снув оруболовия. ʻAʻole heʻokoʻa nui i ka hopena o ka hypotension ma waena o nā huiʻelua (p> 0.05), akāʻo ka emiʻana o ka SBP ma hope o ka hoʻokomoʻana i ka anesthesia iʻoi aku ka nui ma ka hui L0.5 ma mua o ka hui L0 (p <0.01).ʻAʻohe o nā maʻi i hoʻomohala i ka bradycardia a me ka hypoxia.ʻAʻohe mea maʻi i hōʻike i ka nausea, tinnitus, perioral numbness, a me palpitations.ʻO ka maʻi #20 ma ka hui L1.0 ua hoʻomohala i ka myoclonus maka ma hope o ka mua o ka propofol 1.8 mg / kg, a ʻo ka mea maʻi #10 i ka hui L1.5 ua hoʻomohala i ka myoclonus o ka maka a me nā ʻokiʻoki ma hope o ka hopena mua o propofol 1.4 mg / kg..Kū ka Myoclonus ma hope o 30-60 kekona. ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā hui i ka hanana o ka myoclonus (p>0.05). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā hui i ka hanana o ka myoclonus (p>0.05). Достоверных различий между группами по частоте миоклонуса не было (p>0,05). ʻAʻohe ʻokoʻa koʻikoʻi ma waena o nā hui i ka hanana o ka myoclonus (p>0.05).肌阵挛发生率组间差异无统计学意义（p>0.05）。肌阵挛发生率组间差异无统计学意义（p>0.05）。 Достоверной разницы в частоте миоклонуса между группами не было (p>0,05). ʻAʻohe ʻokoʻa nui i ka pinepine o ka myoclonus ma waena o nā hui (p>0.05).
I ko mākou ʻike, ʻo kēia ka noiʻi mua mua e hōʻike ana i ka hopena o nā ʻano like ʻole o ka lidocaine intravenous ma ka ED50 a me ED95 o ka induction dose o propofol i nā maʻi e hana ana i ka hysteroscopy trimester mua.Ua hōʻike ʻia nā hopena i ka hoʻokele intravenous o lidocaine ma kahi ʻano o 1.0 mg / kg ma mua o ka hoʻopiʻi ʻana o propofol i hōʻemi nui i ka ED50, ED95 a me ka nui o ka propofol dosis, ʻo ia ka mea e like me ka hopena o ka hopena o 1.5 mg / kg.No laila ke paipai nei mākou i kahi haʻahaʻa haʻahaʻa o 1.0 mg/kg ma ke ʻano he ʻano kūpono loa no ka lāʻau adjunctive kūpono no ka anesthesia intravenous me propofol.Pīhoihoi mākou i ka ʻike ʻana i ka hoʻokele intravenous o 0.5 mg / kg lidocaine i hoʻonui i ka ED50 o propofol, e hōʻike ana i kahi hopena paʻakikī o ka lidocaine.
Ma muli o ka hoʻomaka wikiwiki o ka hana a me ka wikiwiki o ka hoʻihoʻi ʻana, hoʻohana pinepine ʻia ka propofol no ka sedation i nā kaʻina hana o waho.Eia naʻe, hoʻonui ka nui o ka propofol i ka pilikia o ka apnea, hāʻule ke ala ea o luna, a me ka hypotension, aʻo nā kumu haʻahaʻa i hopena i ka hoʻomaha ʻole.No laila, pono kahi adjuvant maikaʻi e hōʻemi i ka pane ʻana i ka ʻokiʻoki a hoʻemi i ka pono o propofol.I nā makahiki i hala iho nei, ua hōʻike ʻia nā haʻawina he nui i nā hopena analgesic o ka lidocaine intravenous, me ka hoʻemi ʻana i ka ʻeha ma hope o ka injection propofol, ka hoʻemi ʻana i nā koi opioid, a me ka hōʻemi ʻana i ka ʻeha postoperative mau.Ma kā lākou mau ʻōlelo aʻoaʻo i paʻi ʻia, ʻo Foo et al.ʻAʻole i ʻoi aku ma mua o 1.5 mg/kg i helu ʻia me ke kaumaha o ke kino kūpono no ka lidocaine intravenous.I kēia mau lā, ʻo Liu et al.a me Yu et al.Ua hōʻike ʻia ʻo ka hoʻokele intravenous o lidocaine ma mua o ka hoʻokomo ʻana o ka anesthesia i hopena i ka hoʻemi ʻana i ka ED50 o propofol i nā maʻi gastroscopy a me ka hysteroscopy.No laila, ua manaʻo kā mākou noiʻi e hoʻāʻo i ka hopena o nā ʻokoʻa like ʻole o ka lidocaine intravenous ma propofol-induced ED50 a me ED95 i ka wā mua o ka trimester uterine aspiration a e hoʻoholo i ka hopena maikaʻi loa.Hoʻokuʻu mākou i nā maʻi me ka mōʻaukala o ka hānau ʻana a me ka mea i loaʻa i ka cervical dilatation i loko o 6 mau mahina no ka mea ua manaʻo mākou ʻo nā mea maʻi me ka mōʻaukala o ka hānau ʻana a i ʻole ka mōʻaukala o ka cervical dilatation ʻoi aku ka liʻiliʻi o ka hoʻoulu ʻana o ka cervical i ka wā o ka ʻokiʻoki ʻana ma mua o ka poʻe maʻi ʻaʻohe mōʻaukala o ka cervical dilatation.ka hoʻomāhuahua ʻana o ka ʻōpū o ka mea maʻi.28 Hiki i kēia ke alakaʻi i nā hopena pololei.
ʻO ka lidocaine intravenous he hapalua o ke ola o 5-8 mau minuke, e hoʻomaka ana mai ka moena vascular a komo i loko o nā ʻiʻo peripheral, ma mua ma nā wahi o ka perfusion kiʻekiʻe (naʻau, ʻāmāmā, ate, spleen), a laila i nā wahi o ka hypoperfusion.ʻiʻo a me ka ʻiʻo adipose).10 I kā mākou noiʻi ʻana, hāʻawi mākou i ka lidocaine ma mua o ka hoʻokomo ʻana o propofol e mālama i kāna kaila plasma i loko o ka pae kūpono.ʻO ka hopena,ʻo ka hoʻohanaʻana i ka 1.5 mg / kg lidocaine ma mua o ka propofol ka hopena i ka 26% o ka emiʻana o ka ED50 o ka propofol, aʻo ka 1.0 mg / kg lidocaine ka hopena i ka 30% ho'ēmi.Ua kūlike kēia mau hopena me nā hopena o Liu a me Xu, e hōʻike ana i ka lidocaine i kēia mau kau he analgesic a me nā hopena antihyperalgesic.ʻO ka mea kupanaha, ua hoʻonui ʻia ka ED50 me ka lidocaine intravenous ma 0.5 mg / kg, e hōʻike ana e hiki ke hoʻohuli ʻia ka hopena o ka hopena o ka 0.5 mg / kg a hiki ke hoʻopili ʻia nā haʻahaʻa haʻahaʻa loa o ka lidocaine intravenous me nā hopena hypersensitivity koʻikoʻi e pili ana me ka hopohopo. ʻoluʻolu.Hana ʻo Lidocaine i nā pahuhopu molekala he nui e pili ana i ka nociception acute a me ka maʻi, e komo pū me N-methyl-D-aspartate (NMDA) a me muscarinic cholinergic (m1, m3), ʻo ia ka 100-1000 mau manawa ʻoi aku ka maʻalahi ma mua o nā pahuhopu ʻē aʻe.20,29 ʻO ka NMDA, m1 a me ka m3 mau mea hoʻokipa e hoʻomau i ka maʻalahi ma nā lidocaine ma lalo o nā kiko plasma pili pili.Lidocaine inhibits the activation of human NMDA receptors at nanomolar concentrations with maximum inhibition in the millimolar range, resulting in pain relief.Hana ʻo Lidocaine i nā mea hoʻokipa muscarinic cholinergic i ke ʻano o ka manaʻo a me ka manawa.ʻO Claes et al.ua hōʻike i ka hoʻohana ʻana o ka lidocaine i loko o nā doses o 10 a me 30 mg / kg i hoʻonui i ka hoʻokuʻu intraspinal acetylcholine a hoʻoulu i ka analgesia waena ma o ka hoʻoulu ʻana i nā mea hoʻokipa muscarinic i nā ʻiole, akā ʻaʻole i hoʻonui nui ʻia ka lidocaine 1 mg / kg lidocaine intraspinal acetylcholine.30,31 Ua hōʻike pū nā haʻawina i ka lidocaine poloka i ka m1 a me ka m3 muscarinic receptors ma nā haʻahaʻa nanomolar haʻahaʻa (IC50 o 18 nM no ka m1 a me 370 nM no ka m3).Eia kekahi, ʻo ka lōʻihi o ka hoʻolaha ʻana i ka lidocaine ma IC50 i hopena i kahi hoʻololi biphasic o ka m1 a me ka m3 receptors me ka inhibition mua ma hope o 8 mau hola ma hope o ka hoʻonui ʻana i ka hōʻailona.32 No laila, ʻo kā mākou bolus hoʻokahi o nā lidocaine lidocaine 0.5 mg / kg me ka ʻole o ka hoʻolaha lōʻihi e hiki ke hana pono ma o ka pale ʻana i nā mea loaʻa m1 a me m3.ʻOi aku ka haʻi ʻana o ka inhibition o ka m1 a me ka m3 receptors, hiki ke wehewehe i ka piʻi ʻana o ED50 i ka hui L0.5 i kā mākou noiʻi.Eia nō naʻe, i kā mākou aʻo ʻana, ʻaʻole mākou i ana i ka plasma concentration o lidocaine.Pono ka noiʻi hou a me ka hōʻoia e hōʻoia i kēia manaʻo.
ʻO ka nui o ka nui o ka propofol i koi ʻia no ka hana holoʻokoʻa i ʻoi aku ka kiʻekiʻe ma nā pūʻulu L0 a me L0.5 ma mua o nā hui ʻelua.ʻO ke alapine o ka hanu hanu i loko o ka hui L0.5 iʻoi aku ka kiʻekiʻe ma mua o nā hui L0 a me L1.0.ʻO ka emiʻana o ka SBP ma hope o ka hoʻokomoʻana i ka anesthesia ma ka hui L0.5 iʻoi aku ka nui ma mua o ka hui L0.ʻAʻole kekahi o nā mea maʻi i hoʻomohala i ka hypoxia, ʻoiai mākou i hana i ka hoʻokiʻekiʻe ʻana a i ʻole ka mask ventilation i ka manawa kūpono.ʻO ka nui o ka nui o ka propofol, ke alapine o ke kaumaha o ka hanu, a me ka emi ʻana o ke koko systolic ma hope o ka hoʻokomo ʻana o ka anesthesia ma ka hui L0.5 i manaʻo ʻia e hiki i nā kiʻekiʻe o propofol ke hoʻonui i ka pilikia o ka hanu a me ke kahe o ke kahe.ʻAʻohe ʻokoʻa i ka hopena o nā hanana ʻino ma waena o nā hui L0, L1.0 a me L1.5.Eia naʻe, hāʻawi ʻia i ka hoʻolālā ʻana o kā mākou noiʻi, ʻo ka mean propofol-inducing dose i kēlā me kēia hui kokoke i ka ED50 akā ma lalo o ka ED95.No laila, uaʻoi aku ka nui o ka hopena o nā meaʻino inā ua hoʻokomoʻia nā maʻi o ka hui L0 me propofol ma kahi o ED95 (2.8 [2.6-3.2] mg / kg).Eia naʻe, ua loaʻa ka hopena o ka lidocaine i kahi ED95 o 2.0 (1.9-2.4) mg / kg a me 2.1 (1.9-2.4) mg / kg i nā hui L1.0 a me L1.5, i kēlā me kēia, ma nā haʻahaʻa haʻahaʻa.ʻO ke kūkākūkā ma luna nei e wehewehe i ke kumu e manaʻoʻiʻo ai mākou he mea pono ka hopena analgesic o ka lidocaine intravenous i nā kau kūpono a i ka manawa kūpono i ka hoʻohaʻahaʻa ʻana i nā pilikia anesthesia i hoʻokomo ʻia e propofol.I kā mākou noiʻi ʻana, ʻaʻohe ʻokoʻa koʻikoʻi i ka ED50, ka nui o ka propofol dose, ka manawa ala, a me nā hanana ʻino ma waena o nā hui L1.0 a me L1.5.No laila ke paipai nei mākou i kahi haʻahaʻa haʻahaʻa o 1.0 mg / kg IV lidocaine ma ke ʻano he ʻoi loa.
Aia kekahi mau palena o kā mākou haʻawina.ʻO ka mea mua, ʻo nā mea maʻi wale nō me ASA I a i ʻole II i hoʻokomo ʻia i loko o kēia haʻawina, akā ʻo nā mea maʻi me ASA III a i ʻole IV paha e ʻoi aku ka maʻalahi o ka hanu a me ka puʻuwai cardiovascular i ka wā e lawe ai i ka propofol.33 Eia kekahi, ʻo nā wahine hāpai a pau i komo i kēia haʻawina, a pili paha nā hopena i nā ʻokoʻa physiological, nā ʻokoʻa o ka heluna kāne.ʻO ka lua, hoʻohana mākou i ka helu MOAA / S ma ke ʻano he hōʻailona o ke kiʻekiʻe o ka sedation ma mua o nā hōʻailona pahuhopu e like me ka nānā ʻana o BIS.34 ʻO ke kolu, ua lawelawe ʻia ka lidocaine ma ke ʻano he bolus hoʻokahi a ʻaʻole mākou i ana i nā pae plasma o lidocaine.ʻO ka hope, hoʻoholo ʻia ʻo ED95 e ED50, no laila pono ka noiʻi hou aʻe no ka loaʻa ʻana o ka ʻikepili pololei.
ʻO nā hopena o kā mākou noiʻi ʻana i kēia manawa ua hōʻike ʻia ʻo ka hoʻokele intravenous o 1.0 mg/kg lidocaine ma mua o ka propofol injection i hoʻemi nui i ka ED50, ED95, a me ka nui o ka propofol dose i nā poʻe maʻi e hana ana i ka hysteroscopy ambulatory mua-trimester ma lalo o ka anesthesia, e like me ka hopena kūpono o 1.5 mg / kg.Manaʻo mākou i kahi maʻa o 1.0 mg / kg ka mea kūpono loa.ʻO ka mea kupanaha, ua hoʻonui ʻia ka ED50 o propofol i ka intravenous dose o 0.5 mg / kg lidocaine, e hōʻike ana i kahi hopena paʻakikī o ka lidocaine.Pono nā noiʻi hou aʻe o nā mīkini kumu e hōʻoia i kā mākou hopena.
Hiki ke loaʻa nā ʻikepili i loaʻa i ka wā o ke aʻo ʻana mai ka mea kākau pili (Ni Huang).
Makemake au e hoʻomaikaʻi aku iā Kauka Huang Han mai kā mākou ʻoihana a me nā kahu hānai ma ka lumi hana no kā lākou kākoʻo ikaika.
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