异丙酚联合芬太尼清醒镇静镇痛在超导可视无痛人流术中的应用

Conscious sedation analgesia with propofol and fentanyl infusion for superconducting visual painless abortion

目的研究异丙酚联合芬太尼清醒镇静镇痛用于超导可视无痛人流术的有效性、安全性和可行性。方法选择ASAI级拟行超导可视无病人流术的患者60例，将其随机分为两组，清醒镇静镇痛组（A组）和对照组（B组），每组30例。A组：芬太尼1μg／k、异丙酚1．5～2．0mg/kg；B组：异丙酚2．0～3．0mg／kg；A、B两组均视患者体动情况给予缓慢静脉注射异丙酚0．25～0．50mg/kg观察记录两组患者术前和术中平均动脉压（MBP）、心率（HR）、呼吸频率（RR）、经皮脉搏血氧饱和度（SpO2），记录呼吸抑制、心动过缓及警觉／镇静评分。结果两组患者在给药结束时的MBP、HR、SpO2均较基础值有显藉降低（P〈0．05）。手术开始后略有回升，但两组间的变化幅度比较差异无统计学意义（P〉0．05），A组发生重度呼吸抑制的比率明显少于B组（P〈0．05），A组患者术毕神志恢复较B组迅速，差异有统计学意义（P〈0．05）结论异丙酚联合芬太尼清醒镇静镇痛用于超导可视无痛人流术能达到满意的麻醉效果，是一种安全、有效、可行的麻醉方法。

Objective To study the validity, safety and feasibility of conscious sedation analge- sia with propotol and fentanyl infusion for superconducting visual painless abortion. Methods Sixty ASA （American society of anesthesiologist） I patients undergoing superconducting visual painless abortion were randomly divided into two groups： conscious sedation analgesia group with propofol and fentanyl, control group with propofol only. The levels of MAP, HR, SpO2 and recovery time and OAA/S scoles were evaluated, analyzed and compared during operation. Results The changes of MBP, HR, SpO2 in control group in operation were obvious compared with baseline before operation, and which of conscious sedation analgesia group were relatively stable. Lower respiratory supression and more rapidly recover consciousness was observed among conscious sedation analgesia group. Conclusions Conscious sedation analgesia with propofol and fentanyl infusion is feasible for superconducting visual painless abortion, which has advantages of saving drug, safety and good effect.