口服曲马多辅助丙泊酚无痛人流术效果观察

Effect of propofol combined with tramadol on induced abortion

目的观察口服曲马多缓释片辅助丙泊酚无痛人工流产术的麻醉效果。方法早孕妇女80例,随机分为两组(n=40):口服曲马多辅助丙泊酚组(PT组)和丙泊酚(P组)。PT组予术前1h口服盐酸曲马多缓释片100mg(1片)。两组均按丙泊酚2.0mg/kg诱导,术中维持每次追加丙泊酚0.5～1.0mg/kg,记录丙泊酚用量、意识恢复、自由对答和自行离去时间、呼吸和循环监测指标、苏醒期有无宫缩痛及疼痛程度(VAS评分)。结果两组注射丙泊酚麻醉诱导后1min的MAP和SpO2明显降低(P<0.05),但均在正常范围,组间比较无明显差别(P>0.05);PT组丙泊酚用量明显少于P组(P<0.05);PT组丙泊酚注射痛和术后宫缩痛明显低于P组(P<0.05),PT组呼吸抑制发生率明显低于P组(P<0.05)。结论无痛人工流产术病人,术前口服曲马多缓释片可减少丙泊酚麻醉用药量,减轻丙泊酚注射痛,降低呼吸抑制和术后宫缩痛发生率。

Objective To investigate the clinical effect of propofol combined with oral trmadol hydrochoride sustained-release tablet on induced abortion.Methods 80 pregnant women were randomly divided into 2 groups：the propofol combined with trmadol group（PT group）and the propofol group（P group）.The cases were respectively administered with oral tramadol hydrochloride sustained-release tablet 100 mg（1 table） 1 hours before operation in the PT group.And then anesthesia was induced with propofol 2 mg/kg in all cases,and was maintained with propofol 0.5~1.0 mg/kg.The propofol dosage,time of consciousness recovery,smooth reply and leaving from hospitals,monitoring parameters of respiratory and circulatory system,pains of uterine contractions and scores of visual analogue scale（VAS） were recorded.Results The MAP and SpO2 at 1 min after anesthesia was induced with propofol,both of them are decreased significantly in the normal range（P〈0.05）and there was no obvious difference between two groups.The quantity of propofol used,the degree of pains of intravenous injection and the postoperative pains of uterine contraction,respiratory inhibition rate were significantly lower in PT group than those in P group（P〈0.0 5）.Conclusion Preemptive analgesia using oral tramadol hydrochloride sustained-release tablet can decrease the quantity of propofol used,the degree of pains of intravenous injection and respiratory inhibition rate during anesthesia,it also can decrease the incidence and degree of postoperative pains of uterine contraction during recovery period after painless induced abortion with propofol.