地佐辛复合异丙酚深镇静在人工流产术中的临床应用

Clinical Application of Deep Sedation with Dezocine and Propofol in Induced Abortion

目的:研究地佐辛复合异丙酚深镇静在初次人工流产术中应用的有效性和安全性。方法:138例患者分别在宫颈1%利多卡因局部麻醉(L组)、芬太尼1.5 ug/kg(F组)或地佐辛0.1 mg/kg(D组)复合异丙酚深镇静下接受初次人工流产手术。围术期监测血流动力学(HR、MAP、RR、SpO_2);记录术中异丙酚追加、患者体动、呼吸抑制发生情况及术后术者麻醉满意度、患者VAS评分、眩晕、恶心呕吐发生情况。结果:F、D组诱导后各时点HR、MAP、RR及术后VAS评分、术者麻醉满意度评分较L组低;D组术中RR较F组高。结论:深镇静可为接受初次人工流产手术的患者提供较宫颈局麻更好的镇静及镇痛效果;复合异丙酚深镇静时,地佐辛可提供与芬太尼相近、令人满意的镇痛效果,同时呼吸抑制轻微,是人工流产手术有效的麻醉方案。

Objective： To evaluate the efficacy and safety of deep sedation with dezocine and propofol in the first trimester induced abortion. Methods： 138 patients undergoing induced abortion were enrolled. 41 patients were chosed the cervical local anesthesia （group L）, the rest were randomly allocated into either fentanyl group （group F） or dezocine group （group D）, in which patients received abortion under deep sedation with propofol and fentanyl or dezocine, respectively. Vital signs, occurrence of respiratory suppression, VAS score and satisfaction of provider were recorded. Results： MAP, HR, RR and VAS score were significantly lower in group F and D than that in group L, RR was higher in group D than in group F after anesthesia induction. Meanwhile, the surgical provider was well satisfied with the anesthesia in group F and D. Conclusion： Deep sedation provided better analgesic effects in first trimester induced abortion when compared with traditional cervical local anesthesia. With a minor respiratory suppression, the application of dezocine and propofol seems to be safe and efficient.