瑞芬太尼靶控输注复合丙泊酚、多沙普仑用于无痛人流术的临床观察

Clinical observation of target-controlled remifentanil infusion combined with propofol and doxapram in painless artificial abortion

目的观察多沙普仑对瑞芬太尼靶控输注复合丙泊酚用于人工流产手术麻醉效果及呼吸、循环的影响。方法120例ASAⅠ级自愿接受无痛人流术患者,随机分为两组,每组60例,分别给予瑞芬太尼靶控输注(效应室浓度2ng/ml)+丙泊酚1mg/kg(Ⅰ组)或瑞芬太尼、丙泊酚+多沙普仑0.6mg/kg(Ⅱ组)观察麻醉效果及呼吸、循环的变化。结果两组麻醉效果好,脑电双频指数无明显差异;诱导时间、苏醒时间无显著性差异(P>0.05),Ⅰ组呼吸频率、脉搏血氧饱和度、平均动脉血压、心率与Ⅱ组相比在意识消失时、扩宫时、宫内吸引时有显著性差异(P<0.05)。结论多沙普仑可减弱无痛人流术中瑞芬太尼靶控输注复合丙泊酚麻醉的呼吸循环抑制作用,而对其麻醉效应无影响。

Objective To observe the impacts of doxapram on anesthetic efficacy and respiratory and circulatory functions during anesthesia with remifentanil given by target-controlled infusion （TCI） combined with propofol in painless artificial abortion. Methods A total of 120 ASA Ⅰ women reguiring voluntarily painless artificial abortion were randomized into two equal groups. One group was given remifentanil by TCI at 2 ng/ml and propofol lmg/kg （group Ⅰ）, and the other given remifentanil by TCI, propofol, and doxapram 0.6 mg/kg （group Ⅱ）. The anesthetic efficacy and respiratory and circulatory suppression during anesthesia were observed. Results Both of the two groups showed satisfactory anesthetic efficacy with comparable the BIS values （P〉0.05）. No significant difference was noted in the induction time and awaking time between the two groups （P〉0.05）, but group Ⅰ had more serious respiratory and circulatory depression than group Ⅱ （P〈0.05）. Conclusion Doxapram may attenuate respiratory and circulatory depression during anesthesia with remifentanil given by TCI combined with propofol in painless artificial abortion, and provide comparable anesthetic efficacy.