依托咪酯乳剂复合舒芬太尼用于无痛人工流产手术麻醉的临床观察

Etomidate-Sufentanil Used for Artificial Abortion

目的观察依托咪酯乳剂复合舒芬太尼用于人工流产手术麻醉的效果。方法选择ASA Ⅰ～Ⅱ级早期妊娠需人工流产患者150例,随机分为A组(单纯依托咪酯乳剂组);B组(依托咪酯乳剂复合0.10μg/kg舒芬太尼组);C组(依托咪酯乳剂复合0.15μg/kg舒芬太尼组)。监测收缩压、舒张压、心率、脉搏血氧饱和度,记录依托咪酯乳剂用量、手术时间、清醒时间、肌颤发生例数、术后宫缩痛评分及定向力恢复情况。结果三组患者生命体征变化无显著性差异。C组依托咪酯乳剂用量明显少于A组。B组和C组与A组比较清醒时间显著缩短,肌颤发生率显著降低。术后30分钟,B、C两组的宫缩痛VAS评分均明显低于A组;C组VAS评分低于B组;术后1小时,C组VAS评分低于A组。术后定向力恢复均良好。结论依托咪酯乳剂复合舒芬太尼0.15μg/kg实施无痛人工流产手术,患者生命体征平稳,并可减少依托咪酯乳剂的用量和肌颤的发生率,缩短术后清醒时间,加强术后宫缩痛的镇痛作用。

Objective To investigate the effects of etomidate-sufentanil used for artificial abortion. Methods One hundred and fifty ASA Ⅰ-Ⅱ pregnancies were randomly divided into three groups： etomidate group （group A ） ; etomidate and sufentanil （0.10μg/kg） （ group B） ; etomidate and sufentanil （0.15μg/kg） （ group C）. All pa- tients in the three groups were admin istrated with etomidate O. 2mg/kg, superadded etomidate 0.05 -0. lmg/kg when necessary during the operation. Group B, 0.10μg/kg sufentanil was admin istrated before the administration of etomidate; Group C ,0. 15μg/kg sufentanil was administrated . Vital signs, etomidate dosage, revival time, postoperative VAS scores of uterotonic pains were recorded. Results There was no significant change in HR,SBP, DBP,SPO2 in the three groups . Etomidate dosage in group C was significantly less than that in group ARevival time in group B and C was significantly shorter than that in group A. More patients in group A deveh）ped amyostasia than the other two groups. VAS scores of uterotonic pains in group A was significantly higher than that in group B and C. Conclusion 0.15μg/kg sufentanil used in the induction of anesthesia for artificial abortion can reduce the etomidate dosage needed, lower the incidence of amyostasia and make patients feel better after the operation. It is a safe and effective method for the anesthesia of artificial abortion.