小剂量盐酸多沙普伦改善无痛人工流产非插管全麻中患者血气状态的研究

Low dose doxapram improves blood gas in patients undergoing painless artificial abortion during general anesthesia without tracheal intubation

目的 观察无痛人工流产患者术中的血气状态以及小剂量盐酸多沙普伦对其的干预效果.方法 将40例在丙泊酚-芬太尼催眠镇痛术下行人工流产的患者随机分成观察组和对照组.待患者入睡即刻,观察组静脉注射盐酸多沙普伦0.4mg/kg（稀释至5ml）,对照组静脉注射等量0.9%氯化钠注射液,在用药前及用药后3、8min 3个时点抽取患者的动脉血做血气分析,同时观察并记录各时点患者的呼吸频率（RR）、潮气量（Vt）、脉搏血氧饱和度（SpO2）和相关并发症.结果与对照组比较,观察组患者在注射盐酸多沙普伦后3min Vt明显增加,动脉血氧分压（PaO2）、动脉血氧饱和度明显升高（P＜0.05）;注药后8min两组RR、动脉血二氧化碳分压的差异无统计学意义（P ＞0.05）,但Vt、PaO2的差异仍有统计学意义（P＜0.05）.结论小剂量盐酸多沙普伦可以显著改善人工流产术中患者因丙泊酚、芬太尼催眠镇痛所导致呼吸抑制引起的血气状态改变.

Objective To investigate the effects of low dose doxapram hydrochtoride on blood gas in patients undergoing painless artificial abortion during general anesthesia without tracheal intubation. Methods Forty patients scheduled for painless artificial abortion were divided into doxapram group and control group randomly. The patients in doxapram group were injected with doxapram hydrochloride 0.4mg/kg （5ml） when patients reached unconsciousness, and the patients in control group were given 0.9% sodium chloride injection instead. The respiratory rate （RR）, tidal volume （Vt）, oxygen saturation （SpO2） and the results of arterial blood gas analysis were measured before and 3min, 8min after doxapram injection, and the related complications during operation were observed. Results At 3min after doxapram injection, the SaO2, PaO2, RR, SpO2, Vt were higher and the PaCO2 was lower in the doxapram group compared to control group （all P〈 0.05）. At 8min after doxapram injection, PaO2 was higher in the doxapram group （P〈 0.05）, and there were not significantly differences in the RR, SpO2, Vt and PaCO2 between two groups. Conclusion Low dose doxapram hydrochloride can reverse the respiratory depression and improve the aggravation of blood gas induced by combination of propofol with fentanyl during painless artificial abortion.