芬太尼对异丙酚注射痛及流产术中镇痛效果的影响

Effects of Fentanyl on Pain Caused by Propofol Injection and Induced Abortion

目的：观察芬太尼和利多卡因对异丙酚注射痛及人工流产术中镇痛效果的影响。方法：90例ASAⅠ～Ⅱ级人工流产妇女随机分为三组，每组30例。对照组：异丙酚注射前给予生理盐水2ml；利多卡因组：异丙酚注射前给予l％盐酸利多卡因2ml；芬太尼组：异丙酚注射前给予25μg／ml芬太尼2ml。采用4级口述描绘评分法（VRS）观察异丙酚注射痛程度；记录术中身体扭动的例数及苏醒时间。结果：芬太尼组和利多卡因组之间注射痛无差异，但均明显低于对照组（P〈0．01）。利多卡因组和对照组术中身体扭动例数无差异，但均高于芬太尼组（P〈0．05）。三组之间苏醒时间无明显差异。所有病例均在30min内安全离院。结论：芬太尼和利多卡因均能明显降低异丙酚注射痛，同时芬太尼还能减轻流产手术所致的疼痛反应。小剂量芬太尼辅助异丙酚用于人工流产术具有可靠的安全性。

Objective： To assess the effect of fentanyl and lidecaine on propofol - induced injection pain and vacuum abortion -induced pain. Method： 90 ASA grade Ⅰ -Ⅱ women scheduled for ambulatory pregnancy termination were randomly divided into three groups： The control group （ n = 30 ） received normal saline 2 ml before propofol injection; Lidocaine group（n =30） received 1% lidecaine 2 ml before propofol injection; Fentanyl group（ n =30） received 25μg/ml fentanyl 2 ml before propofol injection. Pain at the time of propofol injection was assessed using a four - point verbal rating scale. The number of writhes during the operation and the recovery time of consciousness were recorded. Result：The propofol injection pain in fentanyl group was similar to that in lidecaine group, and the propofol injection pain in fentsnyl group and lidocaine group were less than those in control group（ P 〈0.01 ）. The number of writhes in fentanyl group were fewer than those in lidecaine group and control group （P 〈 0.05 ）, and the number of writhes in lidecaine group were similar to those in control group. The recovery time of consciousness in three groups were similar. All patients left hospital safely in 30 minutes. Conclusion： Fentanyl and lidecaine can effectively reduce the propofol injection pain, and fentanyl can decrease the vacuum abortion -induced pain. Propofol plus small doses fentanyl as .general anesthetics for early termination pregnancy is a safe method.