针灸和丙泊酚联合用于无痛人工流产手术的可行性研究

Anestuetic effect of infused propofol combined with acupuncture and moxibution in painless artificial abortion

目的：探讨针灸和丙泊酚联合用于无痛人工流产手术的可行性和安全性。方法：选择自愿要求实行无痛人工流产的患者80例,平均年龄20-40岁,孕期43-56 d,体重45-65 kg,心功能Ⅰ-Ⅱ级,ASAⅠ-Ⅱ级,分为A、B两组,各40例,A组为对照组给予丙泊酚2.0-2.5 mg/kg,B组为试验组先行针刺足太阴、手阳明穴,然后静脉注射丙泊酚1.5-2.0 mg/kg。待患者意识消失后开始手术,两组患者若术中扭动而影响手术操作,可酌情静脉注射丙泊酚0.6 mg/kg。记录患者丙泊酚用量、针灸时间、手术时间、清醒时间、离院时间。结果：B组术中镇痛效果好于A组,术后子宫收缩痛也较A组轻,且丙泊酚用量明显少于A组,两组比较差异均有统计学意义（P〈0.05）。结论：针灸和丙泊酚联合用于无痛人工流产手术,麻醉效果满意,丙泊酚的用量少,术中循环稳定,术后麻醉恢复迅速,此方法可以安全用于门诊无痛人工流产手术。

Objective To observe the feasibility and anesthetic effect of infused propofol combined with acupuncture and moxibution in painless artificial abortion.Method Eighty patients who would receive elective painless artificial abortion were randomly divided into two groups：group A：40 patients received propofol 2.0-2.5 mg/kg,iv;group B：40 patients inserted the taiyin channel of foot and the yangming channel of hand,after the patients infused 1.5-2.0 mg/kg propofol.The time of acupuncture and moxibution,the lasting time of operation,the time of consciousness,the maximum pain block plane,intraoperative use of medicines,and hemodynamics were observed.ECG,NIBP,and SpO2 of patients were continuously monitored.The BP and HR of patients were recorded as statistical indicators.Results The time of reaching the maximum block plane,and the maximum degree of painless were better in group B than those in group A,and there was a statistically significant difference（P〈0.05）.The time of consciousness and leaving was shorter in group B than those in group A,and there was a statistically significant difference（P〈0.05）.Conclusion Infused propofol combined with acupuncture and moxibution can be used in painless artificial abortion,and has no effect on BP,and the function recovers soon after surgery,therefore it is a safe and effective anesthetic method suitable for painless artificial abortion.