丙泊酚、丙泊酚复合瑞捷用于无痛人流的效果比较

To Explore Effects of Propofol Plus Remifentanil on Analgesic Artificial Abortion

目的探讨丙泊酚、丙泊酚复合瑞捷用于无痛人工流产术中的疗效,以期指导临床工作。方法选178例早孕要求流产的孕妇随机分为丙泊酚组(A组)和丙泊酚复合瑞捷组(B组),每组各89例,观察比较两组的镇痛效果、术中受术者反应情况、用药量及唤醒时间。结果A组丙泊酚的诱导剂量及术中追加量明显高于B组(p<0·05);A组于操作1,5,10min时MAP、HR明显高于B组;A组睁眼时间、定向力恢复时间、离院时间与B组比明显延长(p<0·05);VAS评分A组明显高于B组(p<0·05);术中躁动发生率A组明显高于B组(p<0·05)。结论丙泊酚复合瑞捷用于无痛人工流产减少了单纯应用丙泊酚的不足,且缩短了受术者唤醒时间,提高了麻醉效果,值得推广应用。

Objective To explore effects of propofol plus remifentanil on analgesic artificial abortion. Method 178 patients undergoing analgesic artificial abortion were randomly divided into two groups： group A and B. Patients in group A receiving propofol （1.5-2. 0 mg/kg） intravenously and those in group B receiving propofol （1.5-2.0 mg/kg） and remifentanil （1 μg/kg） instead. Propofol was increased according to the response of patients. The anesthetic effect, response during the operation, dosage and induction time were observed and compared between the two groups. Results The initial and later increased dosage of propofol in group A were markedly higher than those in group B （p〈0. 05）. MAP and HR measured at 1, 5, 10 minutes after operation were significantly higher in group A than in group B. Time needed to open eyes, restore consciousness and leave hospital was significantly longer in group A than in group B （p〈0. 05）. VAS value was considerably higher in group A than in group B （p〈0. 05）. Restlessness was more often occurred in group A than in group B （p〈0. 05）. Conclusion The infusion of propofol plus remifentanil in painless artificial abortion was superior to that of propofol alone. It shortened the awaken time, enhanced the anesthetic effects and should be extended in the clinic.