异丙酚复合瑞芬太尼在无痛流产术中的应用

PROPOFOL IN COMBINATION WITH REMIFENTANIL FOR PAINLESS INDUCED ABORTION

目的探讨异丙酚复合瑞芬太尼用于无痛流产的麻醉效能。方法120例拟行无痛流产的病人,随机分为2组,每组60例。术中A组仅单纯靶控输注(TCI)10g/L的异丙酚,设定血浆靶浓度为8.0mg/L;B组在输注异丙酚前1min给予瑞芬太尼0.4μg/kg体质量,并设定异丙酚的血浆靶浓度为5.0mg/L。监测生命体征的变化、呼吸抑制程度、苏醒时间、术中体动情况、术后宫缩痛时间及异丙酚的用量等。结果两组病人呼吸抑制发生率、苏醒时间比较差异无显著性(P>0.05)。术中体动发生率、术后宫缩痛发生率及异丙酚用量B组明显减少(χ2=24.51、22.32,t=84.60,P<0.01)。结论异丙酚复合瑞芬太尼用于无痛流产明显改善了术中体动及术后宫缩痛,并减少了异丙酚的用量,使无痛人工流产术更加安全有效。

Objective To evaluate the anesthetic efficacy of Propofol combined with remifentanil for painless induced abortion. Methods This study consisted of 120 patients scheduled for painless abortion, who were evenly randomized to two groups. Target controlled infusion （TCI） of 10 g/L Propofol alone was given to patients in group A, the target level of 8.0 mg/L was set; for those in group B, remifentanil 0.4 μg/kg was given one minute before Propofol, the target level of Propofol was set at 5.0 mg/L. The vital signs, respiratory depression, time of analepsia, physieal mobility, duration of painful uterine contraction after operation and dosage of Propofol used were monitored. Results In terms of respiratory depression and time of regain consciousness, no significant difference was noted between groups A and B （P〉0.05） ; of physical mobility, duration of painful con traction, and dosage of Propofol used, much less was recorded in group B （x^2= 24.51,22.32; t = 84.60;P〈 0.01）. Conclusion Combined modality of Propofol and remifentanil for induced abortion obviously decrease physical moving during surgery, postoperative painful contraction and dose of Propofoi, which makes the abortion safer and more effective.