瑞芬太尼复合异丙酚在人工流产术中的观察与护理

Observation and Nursing of Remifentanil and Propofol in Induced Artificial Abortion

目的探讨瑞芬太尼复合异丙酚在人工流产术的效果及其护理。方法将200例ASAI～II级人流病人随机分为两组,A组以2mg/(kg·min)的速率静脉注入异丙酚至病人睫毛反射和指令性反应消失,术中出现四肢活动则追加异丙酚1mg/kg;B组异丙酚诱导前静注瑞芬太尼0.5μg/kg。术前、术中监测平均动脉压、心率和脉搏血氧饱和度,记录异丙酚首剂量、总剂量、意识消失、苏醒时间及术中、术后不良反应。结果与术前比较,MAP、HR和SPO2A组均下降(P<0.05),B组下降明显(P<0.01);B组异丙酚的首剂量、总剂量、意识消失时间明显低于A组(P<0.01),但苏醒时间与A组差异无统计学意义,术中无知晓、恶梦,病人感觉舒适安全、入睡快、苏醒快,术后恢复良好。结论瑞芬太尼与异丙酚麻醉是一种很好的人工流产麻醉方式。

Objective To investigate the effectiveness of nursing of remifentanil and propofol in induced artificial abortion. Methods 200 cases ASA Ⅰ -Ⅱ class of patients were randomly divided into two groups, group A 2mg/ （kg· min）rate of patients to intravenous propofol eyelash reflex and mandatory reflex. Intraoperative there were additional activities limbs propofol lmg/kg;Group B propofol-induced inlravenous remifentanil 0.5mg/kg. Preoperative,intraoperative monitoring of mean arterial pressure, Heart rate and pulse oximetry recorded the first dose of propofol, the total dose of consciousness disappeared,recovery time after operation and adverse reactions. Results Compared with preoperative, MAR, HR and SPO2 A group were decreased（ P 〈 0.05 ）and in group B was significantly decreased（P 〈 0.01 ）;Group B first dose of propofol, the total dose,lost consciousness significantly lower than in group A （P 〈 0.01 ）, but the recovery time in group A with no significant differences, the operation without knowing, nightmares, patients feel comfortable, secure, sleep fast, fast recovery after a good recovery. Conclusion Remifentanil and propofol anesthesia are a good artificial abortion anesthesia.