日间妇科宫腔手术静脉麻醉用药的 研究进展

Research Progress of Intravenous Anesthesia Drugs in Day-Case Gynecological Hysteroscopic Surgery

摘要: 日间妇科宫腔手术因其微创、高效的特点，对麻醉管理提出了快速、安全、舒适且恢复迅速的高标准要求。麻醉方案的成功关键在于镇静、镇痛与辅助用药的精准选择与协同优化，以平衡手术安全、患者舒适度和术后快速周转。本文旨在系统综述适用于此类手术的麻醉药物选择策略，重点分析以丙泊酚、瑞马唑仑、环泊酚为代表的新型镇静药，以芬太尼、阿芬太尼、瑞芬太尼为代表的阿片类镇痛药，以及昂丹司琼、右美托咪定等辅助用药的药理学特性、临床优势与潜在风险。通过综合比较不同药物麻醉效能、术后恢复质量及对术后恶心呕吐、疼痛等并发症的预防效果，为构建个体化、精准化的日间妇科短小手术麻醉方案提供循证依据与实践指导。

Abstract: Daytime gynecological intrauterine surgeries impose high standards for anesthesia management, including rapid onset, safety, comfort and fast recovery, due to their minimally invasive and highly efficient characteristics. The key to a successful anesthetic regimen lies in the precise selection and synergistic optimization of sedatives, analgesics and adjuvant drugs, so as to balance surgical safety, patient comfort and rapid postoperative turnover. This paper aims to systematically review the selection strategies of anesthetic drugs suitable for such surgeries, with a focus on analyzing the pharmacological properties, clinical advantages and potential risks of novel sedatives represented by propofol, remimazolam and ciprofol, opioid analgesics represented by fentanyl, alfentanil and remifentanil, as well as adjuvant drugs such as ondansetron and dexmedetomidine. By comprehensively comparing the anesthetic efficacy, postoperative recovery quality and preventive effects on complications such as postoperative nausea and vomiting (PONV) and pain of different drugs, this study provides evidence-based basis and practical guidance for constructing individualized and precise anesthetic regimens for short daytime gynecological surgeries.