氯诺昔康用于人工流产术中麻醉效果的比较

Comparison of anesthesia in abortion using Lornoxicam

目的应用氯诺昔康与常规配方的全麻药物行人工流产术,对其临床效果进行比较,以寻求更为安全、有效的麻醉方法。方法将150例自愿接受无痛人工流产的、ASA分级I～Ⅱ级、18～42岁早孕妇女随机分为三组,每组各50例,第1组:单纯力蒙欣2mg/kg静注;第2组:芬太尼100μg静注+力蒙欣2mg/kg静注;第3组:氯诺昔康16mg+力蒙欣2mg/kg静注。患者入室后,开放静脉通道,监测BP、HR和SpO2,取上述分组中的一组药静注,患者睫毛反射消失后开始手术,术中出现躯体扭动追加药物,手术操作过半停止用药,术中常规面罩给氧辅助呼吸,术毕清醒后送入麻醉恢复室,待患者完全恢复、无不适症状后准予自行离院。结果术后疼痛VAS评分第2组和第3组比较差异无统计学意义(P>0.05),但两组均明显低于第1组(P<0.05),麻醉中的效果和对呼吸血压、心率的影响,第2组明显高于第1和第3组(P<0.05)。所有患者术中无记忆,BP变化不大,所有患者呼吸均有抑制,部分患者出现呼吸暂停,HR<55次/min者给予阿托品0.5mg静推一次的仅2例。术中第1组使用力蒙欣用量最多,体动率最高,清醒时间较长,嗜睡,术后腹痛较重;第2组体动小,清醒快,但术中呼吸抑制率较高,术后恶心呕吐率高;第3组效果总体评价好,体动率不高,清醒较快,术后腹痛少且轻,术中呼吸抑制轻。结论三组配方比较,第3组疗效最好,可有效控制手术后创伤疼痛,苏醒快、腹痛少、呼吸抑制轻。

Objective Using Lornoxicam and conventional formulation of entire anesthesia in artificial abortion, the clinical effects were compared to find a more safe and effective anesthesia. Methods 150 cases of voluntary abortion were ASA classification, Ⅰ - Ⅱ class 18 -42 year - old women in early pregnancy were randomly divided into three groups of 50 cases, group 1 simply using 2 mg/kg Propofol intravenous infusion, group 2 using 100 μg Fentanyl and 2 mg/kg Propofol intravenous infusion, group 3 using 16rag chlorine Nuoxi Kang and 2 mg/kg Propofol intravenous infusion. After the patient enters into the operating room, open intravenous access, monitoring BP, HR and SpO2 , taking one of these groups using infusion, the patient surgery starts after the eyelash reflex disappeared, and using more drugs if the body twists, then stop the medication when the operation was more than half, using conventional oxygen mask ventilation during the surgery, after the surgery and conscious recovery,the patient enters into the anesthesia recovery room, until after the patient recovered without symptoms, leaving by themselves is al- lowed. Results Postoperative pain score of VAS 2,the difference between the 3 groups had no significant difference （ P 〉 0. 05 ） but in the two group were significantly lower than those in group 1 （ P 〈 0.05 ）, anesthesia effect on respiration, heart rate and blood pressure effects, the second group was higher than that of first,3 group（P 〈0.05 ）. All the The patient has no memory during the surgery, BP changed a bit, all patients had respiratory inhibition and part of the apnea,0. 5 mg Atropine were given to intravenous once if HR 〈 55 beats per min, and only two eases are applied. Group 1 consumed the maximum amount of Propofol and appeared the highest rate of body movement, awake time is long, lethargy, abdominal pain severely,the rate of body movement in group 2 is lower, awake faster, but it has a higher intraoperative respiratory repression, the rate of postoperative nausea and vomiting is high, group 3 has good effect, body movement rate is not high, awake faster,lighter and less postoperative pain, intraoperative respiratory repression light. Conclusion The best effect is group 3 in comparison of 3 recipes,it may have ef- fective control of postoperative wound pain, faster recovery, less abdominal pain, and lighter respiratory repression.