再论普鲁泊福静脉麻醉人工流产

Re-investigation of propofol anesthesia in artificial abortion

目的 再次研究普鲁泊福在人工流产术上的麻醉。 方法 2 0 0例选择人工流产的早期妊娠女性 ,随机分为给予小剂量芬太尼的普鲁泊福组 (A组 ,n =10 0 )和单纯普鲁泊福组 (B组 ,n =10 0 )。A组在使用普鲁泊福前 1～ 2min静脉给予芬太尼 0 0 5mg。两组均在吸氧 ( 3L/min) 1～ 2min后静脉注射普鲁泊福 (预设速度 5mg/s)。 结果 ( 1)两组实际注药速度一致 ( 4 2mg/s) ,而A组进入麻醉状态的时间早于B组 (P >0 0 5 ) ,并因此普鲁泊福的初量少于B组 (P >0 0 5 )。两组手术时间相似 ,但B组所需普鲁泊福总量明显大于A组 (P <0 0 1) ,并因此B组苏醒时间明显滞后于A组 (P <0 0 1)。 ( 2 )两组均产生一过性 ( 1～ 2min)循环呼吸抑制 ,但其参数均值仍属正常。 ( 3)两组均有较高的睡眠质量 ,且无术中知晓 ,以及醒后多有欣快感。 ( 4 )AB两组分别有 32 %和 5 5 %的做梦率 ,且各有 6例和 9例回答梦幻与性有关。 ( 5 )普鲁泊福注射的局部疼痛发生率 ,AB两组分别为 2 2 %和 5 0 %。 ( 6 )术后下腹痛程度A组明显低于B组 (P <0 0 1)。 结论 单纯普鲁泊福静脉麻醉用于人工流产术并非十分完美 ,预给芬太尼 0 0 5mg辅助的普鲁泊福麻醉明显优越。

Objective To re explore the effects of propofol intravenously anesthesia in artificial abortion Methods 200 pre term pregnant females scheduled for artificial abortion were randomly divided into group A (n =100) that using fentanyl and propofol, and group B( n =100) that using only propofol A small doses of 0 05 mg fentanyl was given intravenously each female at 1～2 min before propofol in group A Had been inhaling a flow of 3 liters oxygen per minute for 1～2 min, each female was intravenously administered propofol pre designed 5 mg per second Results (1) The rates of intravenous propofol were actually the same (4 2 mg/s) in both groups The onset of anesthesia in group A is earlier ( P >0 05) than group B, and therefore the doses of propofol were smaller in group A The operating time was similar in both group, but the total doses of propofol required were significantly ( P <0 01) greater, and therefore conscious reviviscent time from anesthesia was significantly slower ( P <0 01) in group B than those in group A (2) There were centain depression temporarily (1～2 min) on cardiorespiratory systems, but the mean values of parameters of blood pressure, heart rate and SpO 2 were normal in groups (3) There were high sleeping quality and no consciousness during anesthesia in groups, and almost females were happied in reported after consciousness (4) There were different incidences of dreaming with 32% in group A and 55% in group B, respectively Recall contents of dream related to sex were 6 cases in group A and 9 cases in group B, respectively (5) The incidences of local pain attributed to propofol were 22% in group A and 50% in group B Severity of postoperatve bellyache were significantly lower ( P <0 01) in group A than group B Conclusion The venous propofol anesthesia using for artificial abortion is not perfect It is superior that the propofol anesthesia with a priming 0 05 mg dose of fentanyl