氯诺昔康复合丙泊酚、芬太尼用于人工流产的临床研究

Effects of lornoxicam combined with propofol and fentanyl on induced abortion

目的:观察氯诺昔康复合丙泊酚、芬太尼用于无痛人工流产的临床效果。方法:采用双盲法随机将600例早期妊娠妇女分成氯诺昔康组(L组)300例和对照组(P组)300例。麻醉前2h,L组口服氯诺昔康8mg,P组服用安慰剂。麻醉诱导先缓慢静脉注射芬太尼1μg·kg^(-1),1min后再予丙泊酚1.5mg·kg^(-1)静脉注射。术中根据患者反应每次追加丙泊酚20～30mg。观察记录两组诱导时间、苏醒时间、丙泊酚用药总量、呼吸循环参数改变、术后腹痛发生情况和不良反应。结果:术后腹痛L组少于P组(P<0.05),术中丙泊酚用药总量L组少于P组(P<0.05)。两组呼吸循环抑制发生率及诱导、苏醒时间差异无显著性(P>0.05)。结论:氯诺昔康用于无痛人工流产可增强麻醉效果,减少丙泊酚用量,减少术后腹痛的发生率,减轻术后腹痛的程度,值得推广应用。

Objective: To assess the analgesic effects of lornoxicam combined with propofol and fentanyl for the induced abortion period. Methods: A randomized, placebo-controlled and double-blind clinical study enrolled six hundred women who volunteered to terminate the early trimester of pregnancy, who were randomized 1:1 to administer either lornoxicam (8mg) or placebo 2 hours ahead of the surgical anesthesia. All of the patients were anethetized with intravenous fentanyl (1μg·kg^(-1)) and subsequently propofol (1.5mg·kg^(-1)). Additional bolus of of propofol (20～30mg) was infused as needed during the induced abortion. The anesthetic effect was evaluated with the induction and recovery time post anesthesia, the quantity of propofol administered, diastolic blood pressure (DBP), heart rate,SpO_2 postoperative abdominal pain and incidence of adverse events. Results: Lorxicam-treated patients administered less quantity of propofol and experienced less abdominal pain compared with the placebo patients (P<0.05). There were no significant differences in the effects of circulatory and respiratory system, induction and recovery time post anesthesia between these two groups (P>0.05). Conclusion: Combination of lornoxicam to propofol and fentanyl provides more powerful anesthetic effects in the termination of early trimester of pregnancy.