丙泊酚靶控输注在无痛人工流产术中的应用

Clinical application of propofol by target-controlled infusion in painless artificial abortion

目的 比较丙泊酚靶控输注（TCI）静脉给药与手推静脉给药麻醉对无痛人流手术的影响。方法将220例人流术者随机分为2组，Ⅰ组：TCI泵推注丙泊酚，靶质量浓度设定为6—7mg·L^-1，维持时靶质量浓度设定为4-5mg·L^-1，手术结束时停止输药；Ⅱ组：静脉推注给药，丙泊酚诱导量2—2．5mg·kg^-1，手术期间追加丙泊酚50mg左右。分别观察2组诱导、苏醒时间、总药量、麻醉效果及诱导前后平均动脉压、心率、动脉血氧饱和度的变化。结果Ⅰ组诱导、苏醒时间、用药量均少于Ⅱ组（P〈0．01）；2组诱导后平均动脉血压、心率、血氧饱和度均低于术前（P〈0．05），Ⅱ组下降更严重；麻醉效果Ⅰ组优于Ⅱ组（P〈0．05）。结论靶控输注丙泊酚麻醉用于人工流产手术可以减少麻醉用药量，缩短麻醉诱导、苏醒时间，有较好的麻醉效果。

AIM To compare the anesthetic effects of propofol by target-controlled infusion （TCI） by venous injection during painless artificial abortion. METHODS Two hundred and twenty patients scheduled for painless artificial abortion were randomly divided into 2 groups ： TCI group （group Ⅰ ） and venous injection group （group Ⅱ ） . In groupⅠ , the anesthesia was induced dosage at 6 - 7 mg.L^-1 by TCI with propofol, maintained at 4 - 5 mg.L^-1, stopped injecting when operation end. In group Ⅱ： propofol was injected , induced dosage at 2 - 2.5 mg.kg^-1, propofol could be added about 50 mg during the operation . The induction time, recovery time , the total dose of propofol and anesthetic effects in 2 groups were compared . Mean arterial pressure（MAP）, HR, arterial oxygen saturation（SaO2） were recorded before and after induction. RESULTS The induction time , recovery time and total dosage in group Ⅰ were all less than those in group Ⅱ （P 〈 0.01）.MAP,HR and SaO2 after induction in 2 groups were all lower than those before induction （P 〈 0.05） , especially in group Ⅱ . The anesthesia effect was significantly better in group Ⅰ than in group Ⅱ （P 〈 0.05）. CONCLUSION Target-controlled infusion propofol in painless artificial abortion can decrease the dose requirement of propofol, shorten the time of induction and recovery, increase anesthetic effect.