异丙酚复合小剂量芬太尼麻醉用于人工流产术中的临床研究

Clinical study of propofol with low-dose fentanyl in induced abortion

目的观察异丙酚复合小剂量芬太尼在人工流产术中的效果。方法选择门诊自愿要求人工流产而无禁忌证者450例,随机分为3组：异丙酚组（150例）,单次静脉注射异丙酚2mg/kg;复合组（150例）,芬太尼2μg/kg与异丙酚0.8~1.0mg/kg依次静脉注射;对照组（150例）,不用任何镇静镇痛药物。观察镇痛效果、监测心率（HR）、平均动脉压（MAP）、呼吸频率（RR）、氧饱和度（SPO2）、宫颈松弛情况、术中出血量及并发症。结果复合组在麻醉镇痛效果、宫颈松弛效果、并发症方面与异丙酚组无差异,与对照组比较差异有显著性（P〈0.01）;子宫出血量三组之间差异无显著性（P〉0.05）;复合组的苏醒时间、术后离手术床时间、术后孕妇离院时间均较异丙酚组短（P〈0.01）;复合组对心率（HR）,平均动脉压（MAP）、呼吸频率（RR）及氧饱和度（SPO2）的抑制不如异丙酚组明显（P〈0.05）。结论异丙酚复合小剂量芬太尼麻醉除有明显的镇静、镇痛等协同作用外,还有副作用小、价格相对便宜等优点,是一种值得推广应用的无痛人工流产术。

[Objective] To observe the effect of propefol with lowdose fentanyl in artificial abortion. [Methods} 450 cases without contraindications were randomly divided into three groups：the propofol group （150 cases） received propofol 2 mg/kg before operation; the combined group （150 eases ） received fentanyl 2 μg/kg and propefol 0.8-1.0 mg/kg before operation; the control group （150 cases） did not receive any sedatives and anti-pain drugs . To observe the analgesic effec4 heartrate, mean arterial pressure, respiration rate, saturation of oxygen amount of bleed- ing and complication. [Results] The analgesic effect, laxation of cervices and complieafion had no significant differences between the combined group and the propefol group, but the difference between the two groups and the control group was significant （P 〈0.01）; amount of bleeding had no significant difference among three groups （P 〉0.05）. The recovery time, the time of leaving bed after operation and leaving hospital of the combined group were shorter than the propefol group （P 〈0.01）. While the inhibition of heart rate, mean arterial pressure, respiration rate and saturation of oxygen of the combined group was less apparent than that of the propefol group （P 〈0.05）. [Condusions] It is suggested that using intravenous propefol with low-dose fentanyl in artificial abortion has good sedation and analgesia effect, few side effects and low cost. It is one of the good methods in analgesia abortion.