Abstract：Objective: To investigate the application efficacy of two total intravenous anesthesia regimens, remifentanil combined with alfentanil versus propofol combined with alfentanil, during hysteroscopic electrosurgical procedures.Methods: From January 2023 to June 2023, a total of 107 patients undergoing hysteroscopic electrosurgical procedures were included and randomly allocated using a random number table into a control group (n=53) receiving propofol combined with alfentanil anesthesia and an observation group (n=54) receiving remifentanil combined with alfentanil anesthesia. Pain intensity (evaluated using VAS scores), sedation levels (assessed by Ramsay Sedation Scale), vital signs, Modified Aldrete Score (MAS), and adverse reactions were compared between the two groups.Results: Compared with the control group, the observation group showed significantly lower VAS scores at 2 hours and 12 hours postoperatively (P<0.05) and higher Ramsay Sedation Scale scores at 2 hours postoperatively (P<0.05). There were no significant differences in preoperative heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SPO2) between the two groups (P>0.05). However, HR, SBP, DBP, and SPO2 levels were significantly higher in the observation group than in the control group at 5 minutes after the start of surgery and at 2 hours postoperatively (P<0.05). Significant group effects, time effects, and interaction effects were observed for VAS scores, Ramsay Sedation Scale scores, and vital signs (P<0.05). The observation group had higher Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scores at 1, 3, and 5 minutes after surgery compared to the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion: Remifentanil combined with alfentanil provides better pain control and sedation during early postoperative period in patients undergoing hysteroscopic electrosurgical procedures compared to propofol combined with alfentanil. Patients recover faster to a clear consciousness state, and their vital signs are more stable during anesthesia.
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2024, Vol. 30 
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