芬太尼、麻黄碱和丙泊酚序贯用于无痛人工流产术麻醉的观察

Fentanyl,Propofol Anesthesia for Ephedrine and Sequential Observation of Painless Artificial Abortion

目的:观察丙泊酚芬太尼复合液伍用少量麻黄碱用于人工流产的麻醉效果,探讨此类手术合理的静脉药物配方。方法:选择我院2008年1月～2013年1月门诊收治入院的200例自愿终止妊娠的ASAⅠ～Ⅱ级早孕妇女,随机分为两组,每组100例,分别于术前缓慢静注芬太尼2μg/kg 3分钟后,A组丙泊酚2mg/kg,B组丙泊酚2mg/kg+麻黄碱0.08mg/kg诱导,于40～60秒内注完,意识消失后开始手术,观察术中视患者反应情况及连续检测SBP、DBP、HR、SpO2的变化,并观察患者手术的麻醉起效时间、手术时间、出血量、宫腔深度、术后恢复时间、麻醉镇痛效果及不良反应情况。结果:两组患者的麻醉起效时间、手术时间、出血量、宫腔深度、术后恢复时间相比,均差异无显著性(P>0.05);A、B组诱导后SBP、DBP明显下降,HR减慢,与麻醉前比较差异有统计学意义(P<0.05);A组SBP、DBP在麻醉后3min、5min、10min后明显下降,与B组比较差异有统计学意义(P<0.05);A、B两组术中麻醉镇痛效果及术后恢复时间无显著性差异(P>0.05)。B组丙泊酚用量为(92±32)mg。A组丙泊酚用量为(166±67)mg,显然,B组比A组丙泊酚用量少(P<0.05)。与A组比较,B组的不良反应(肢体活动、呼吸暂停)差异有统计学意义(P<0.05)。结论:丙泊酚芬太尼复合液伍用少量麻黄碱用于门诊无痛人工流产手术是一种非常安全和有效配伍方法,值得推广。

Objective：Propofol fentanyl combined with a small amount of liquid ephedrine used for anesthesia in artificial abortion,intravenous drug formulation of this kind of operation is reasonable.Methods：In our hospital in 2008 January ～2013 year in January outpatients from 200 cases of voluntary termination of pregnancy of ASA Ⅰ～Ⅱ pregnant women,were randomly divided into two groups,100 cases in each group,respectively before the slow intravenous injection of fentanyl 2μg/kg 3 minutes later,groupA propofol 2mg/kg,B group of propofol 2 mg/kg＋0.08 ephedrine the induction of mg/kg,from 40 to 60 seconds after injection,lost consciousness after the start of operation,changes in the reaction of patient observation and continuous detection of SBP,DBP,HR,SpO2,onset time,operation time,amount of bleeding,uterine cavity depth,postoperative recovery time,analgesic effect and the adverse reaction of anesthesia and anesthesia.Observation of the patients with operation.Results：The recovery time of onset time,operation time,amount of bleeding,uterine cavity depth,postoperative anesthesia in the patients of the two groups were compared no significant difference（P〈0.05）;A,B group,DBP decreased significantly after induction of SBP,HR decreased,compared with before anesthesia,the difference was statistically significant（P〈0.05）;A group SBP,DBP in 3min,5min,10min after anesthesia was significantly decreased compared with B group,the difference was statistically significant（P〈0.05）;A,B anesthesia analgesia and postoperative recovery time after operation in two groups had no significant difference（P〈0.05）.Group B propofol dosage was（92±32）mg.GroupA propofol dosage was（166±67）mg,obviously in group B than in groupA propofol consumption（P〈0.05）.Compared with group A,the adverse effects of B group（physical activity,apnea） the difference was statistically significant（P〈0.05）.Conclusion：Propofol and fentanyl combined with a small amount of liquid ephedrine for outpatient painless operation is a safe and effective method of compatibility,worthy of promotion.