氯诺昔康合用丙泊酚静脉麻醉在无痛人工流产术中的应用

Application of Lornoxicam as Supplement to Propofol Anaesthesia in Painless Induced Abortion

目的：评价氟诺昔康合用丙泊酚静脉麻醉在无痛人工流产术中的疗效和安全性。方法：美国麻醉学会（ASA）Ⅰ—Ⅱ级妊娠1-2月自愿施行人工流产术的孕妇60例．随机分成治疗组和对照组，每组各30例．对照组为单纯丙泊酚静脉麻醉．治疗组先静注氯诺昔康8mg后行丙泊酚静脉麻醉。2组丙泊酚均采用2次推注法即首次给药至深外镇静，2—3min后扩宫口时再追加首次量的50％。观察诱导过程及术中血压心事脉搏氧饱和度呼吸频率，苏醒时间，丙泊酚用量、术后恶心呕吐（PONV）、头晕、术后宫缩痛（采用VAS评分）。 结时：丙泊酚用量治疗组少于对照组（P〈0.05）呼吸抑制发生率对照组83%，治疗组50％（P〈0.05），术后宫缩痛治疗组明显少于对照组（P〈0.05）；两组术中血压心率脉搏氧饱和度比较差异无显著性。 结论：氯诺昔康合用丙泊酚静脉麻醉行无痛人工流产术可以减少丙泊酚用量和呼吸抑制的发生．增强镇痛效果而不增加不良反应。

Objective： To evaluate efficacy and safety of Iornoxicam as supplement to propofol anaesthesia in painless abortion. Methods： 60 ASA Ⅰ-Ⅱ pregnant women undergoing painless abortion were enrolled and randomly divided into treatment group（n=30） and control group（n=30） Pregnant stage was in the first or second months. In the control group, patients were administrated intravenously propofol alone; In the treatment group, 8 mg lornoxicam was used in combination with propefol. Both groups were infused intravenously by two phases, in first phase drug was used until patients were deepty sedated, in second phase （when utarocervical dilation） 50% initial dose was boosted. Blood pressure, heart rate, SpO2. breath frequency, revival time, propofol dosage, post-operative nausea and vomiting（PONV）, vedigo and postoperative utarotonic pain （adopt VAS grade） in two groups were compared in inducing and maintaining phases. Results： Propofol dosage, postoperative uterotonic pain and rate of breath inhibition in treated group were less than those in control group （P 〈 0.05）, However, it was of no statistical significances in tWO groups for data of btsod pressure, heart rate and SpO2. Conclusions： Lomoxicam can reduce propofol dosage and respiratory inhibition rate, strengthen analgesia effect of propofol without more side effects when used as supptsment to propofol anaesthwsia in painless induced abortion.