不同剂量舒芬太尼复合丙泊酚在无痛人流中的应用

Evaluate the efficacy of propofol combined with different dosage of sufentanil in anaesthesia for painless abortion

【目的】研究不同剂量舒芬太尼复合丙泊酚用于无痛人工流产麻醉的效果。【方法】选择人工流产患者200例，ASAI-Ⅱ级，随机分为5组，每组40例。观察组（SF1、SF2、SF3、SF4组）：丙泊酚分别复合0．05、0．1、0．15、0．2刚k舒芬太尼进行人工流产麻醉；对照组（C组）：单纯应用丙泊酚进行人工流产麻醉。观察SBP、DBP、HR、sPO2，记录丙泊酚的总剂量、手术时间、意识恢复和离床起立时间、术中呼吸抑制和术后清醒程度、宫缩痛及常见并发症。【结果】所有组SBP、DBP、HR术中均有下降，但组间无显著性差异（P〉O．05）；SF3、SF4组sPO2与C组比明显下降（P〈0．05）；SF2、SF3、SF4组丙泊酚总用量与C组比明显减少（P〈0．05），意识恢复时间、离床起立时间无显著性差异（P〉0．05）；SF3、SF4组呼吸抑制的可能性比C组和SFI组高（P〈O．05），清醒程度低于C组（P〈0．05）；SF2、SF3、SF4组术后宫缩痛程度明显低于C组、SF1组（P〈0．05）；其余并发症各组无明显差异（P〉0．05）。【结论】丙泊酚复合适当剂量的舒芬太尼（0．1-0．15μg/kg）用于无痛人工流产麻醉，不仅减少了丙泊酚的总用药量，非常有效地抑制或减轻患者术后宫缩痛，且不影响清醒质量，不增加副作用，从而提高患者的满意率。

[ Objective] To evaluate the efficacy of propofol combined with different dosage of sufentanil in anaesthesia for painless abortion. [Methods] 200 ASA I - Ⅱ pregnant women undergoing painless abortion were randomly divided into five groups （n = 40）： group SF1, SF2, SF3 and SF4 accepted injection of propofol combined with sufentanil at the dosage of 0.05, 0.1, 0.15 and 0.2μg/kg respectively and group C only accepted propofol. Patients, SBP, DBP, HR and sPO2 during anesthesia, total dosage of propofol, operation time, recovery time, standing time, respiratory depression, OAMS scale and uterine contraction pain （ adopt VAS grade） at different time and side effects after operation were recorded. [Results] There was no statistical significances in every group on SBP, DBP, HR, operation time, recovery time, standing time, side effects after operation （ P 〉0.05） . SpO2 and OAMS scale were significantly different in group SF3 and SF4 than those in group C （ P 〈0.05） . Compared with group C, groups SF2, SF3 and SF4 had less overall consumption of propofol （ P 〈 0.05） . Respiratory suppression was greater in group SF3 and SF4 than that in group C and SF1 （ P 〈 0.05）. VAS grade were significantly less in group SF2, SF3 and SF4 than those in group C and SF1. [ Conclusions] Propofol combined with sufentanil at concentration of 0.1 -0.15μg/ kg can reduce prepofol dosage and postoperative uterine pain rate, give better recovery and with fewer complications in painless artificial abortion.