异丙酚联合芬太尼应用于人工流产术

Clinical Application Of A Combination Of Propofol And Fentanyl In Induced Abortion

目的对异丙酚联合芬太尼进行无痛人工流产的镇痛疗效及术中术后反应的观察并论证其方法的临床可推广性。方法对2000年6月～2004年5月360例怀孕6～10周,年龄18～40岁。自愿接受无痛人工流产手术的健康妇女,经完善有关检查无人流及麻醉禁忌症后禁食禁饮4～6小时,由专职麻醉师静脉给药芬太尼0.05g加生理盐水4ml,然后用异丙酚按2～2.5mg/kg体重给药,待生命体征显示麻醉起效后即行吸宫术。观察患者镇痛效果及术中术后生命体征变化和不良反应。结果100%患者镇痛效果满意,90%患者BP、P、R稍降低,但仍然在正常范围,<1%受术者心率明显下降至55次/分以下,0.2%患者呼吸暂时抑制均经积极处理而恢复。1.1%患者谵妄,烦躁,0.2%患者轻度过敏反应。手术时限缩短1～2分钟。无人发生因肌松引起的宫缩乏力至阴道多量出血,无患者出现药物成瘾现象。结论在严密观察及具备术前、术中、术后护理条件下可推广使用异丙酚联合芬太尼静脉麻醉进行无痛人工流产术。

Objective To investigate the analgesic effects and the clinical popularity of a combination of propofol and Fentanyl in painless induced abortion. Method 360 cases of early pregnant women （pregnant six to ten weeks） who were eighteen to forty years old with good health condition were vohntarily scheduled for pregnancy termination by painless induced abortion between June2000 and May2004 in our hospital. After consummate physical examinations and 4 to 6 hours eating and drinking＇s abstention, the professional anesthetist used 0.05g Fentanyl phs 4ml physiological saline, administrated propofol by 2～2.5mg/kg, then we began the surgical abortion. We observed the analgesic effects, the physical change and the adverse reactions all along. Results The analgesic effects of a combination of propofol and Fentanyl in painless induced abortion surgery were 100%. 90% cases＇ BP, P, R reduced hut in a normal range, 〈1% cases＇ heart rhythms reduced to 55times/min obviously, 0.2% cases＇ inhibition of respiration all recovered by active management. About 1.1% cases were in delirious and dysphoria state, 0.2% cases had light allergy reaction. The operation duration shortened 1 to 2 minutes. No uterine atony and large amount of vaginal bleeding caused by muscle relaxant and no drug addiction appeared. Conclusion The combination of propofol and Fentanyl by intravenous anesthesia in painless induced abortion can he popularized under good care conditions.