异丙酚复合芬太尼在门诊人工流产术中的临床应用

Clinical study of propofol combined with fentanyl anesthesia in outpatient artificial abortion

目的探讨芬太尼能否有效加强异丙酚对人流术的镇痛作用。方法选择120例妊娠42～60天的孕妇，随机分成A、B两组。A组单纯采用异丙酚静脉麻醉；B组先静脉给予芬太尼，扩宫前给予异丙酚静脉麻醉。观察两组病例异丙酚使用量、麻醉效果和术后镇痛效果，清醒时间、术前、术中2分钟及术后的NIBP、SpO2、HR等。结果A、B两组患者术中异丙酚总量分别为（140±9）mg和（80±10）mg（P〈0．05）。A组和B组清醒时间分别为（5．6±1．9）分钟和（5．1±1．0）分钟，P〉0．05。B组麻醉效果、镇痛效果明显优于A组；B组术后2分钟SpO2下降明显（P〈0．01）；AB组在麻醉诱导后2min，SBP、DBP、HR均有显著性差异（P〈0．01），但术毕即刻恢复近于术前（P〉0．05）。结论芬太尼能有效地加强异丙酚在门诊无痛人流术中的镇痛作用，可减少异丙酚麻醉诱导用量，又不增加副反应的发生。单纯使用异丙酚麻醉效果较差、镇痛效应弱，伍用芬太尼不但麻醉效果好，镇痛效果加强，且减少异丙酚用量。

Objective To explore whether fentanyl can enhence analgesic effect of propofol in induced abortion of pregnancy. Method 120 cases were devided randomly into 2 groups. A group adopted propofol anaesthesia ,while B group adopted propofol anaesthesia after received fentanyl. Induction dose of propofol ,pain during operation , recovery time and NIBP, SpO2, HR of the before operation ,during operation and after operation. Result The propefol dose in the A group was significantly higher than the B group（ 140 ± 9mg ＆ 80 ± 10mg, P 〈 0.05 ）. The recovery time in the A group was not significantly than the B group（5.6 ± 1.9min ＆ 5.1 ± 1.0min, P 〉 0.05 ）. The pain during operation in the B group was significantly better than in the A group （ P 〈 0.05 ） 2 min after anesthetic induction the group A B showed an apparent decrease of NIBP,SpO2 and HR（P 〈0. 01 ） , but recoverd immediately after operation. Conclusion Fentanyl combined with propofol can enhence analgesic effect of propofol in induced abortion of pregnancy , this combination can reduce the dosage of propofol , and no more side effects are to be Occur.