右美托咪定与丙泊酚用于门诊无痛人流术中麻醉效果的分析

Analysis of the anesthetic effect of Dexmedetomidine and Propofol in outpatient painless artificial abortion

目的研究右美托咪定和丙泊酚分别复合瑞芬太尼麻醉用于门诊无痛人流手术的临床效果。方法120例门诊择期行无痛人流手术的患者,年龄18～40岁,ASA I~Ⅱ级,随机分为两组,每组60例：D组用右美托咪定复合瑞芬太尼做麻醉;P组用丙泊酚复合瑞芬太尼麻醉。记录入室（T0）、诱导后（T1）、扩宫颈（T2）、刮宫（T3）、术毕（T4）及术毕5 min（T5）六个时点的HR、MAP、Sp0和Ramsay评分和术后5 min改良OAA/S评分。观察患者入睡、手术、清醒及留观时间。记录术中呼吸抑制的发生率、肢动反应的发生率、术后寒战和恶心等不良反应。结果 T4时,D组Ramsay评分低于P组（P〈0.05）;T1~T4时,D组SpO2高于P组（P〈0.05）;T1~T4时,D组MAP、HR低于P组（P〈0.05）;术后5 min改良OAA/S评分D组高于P组（P〈0.05）;患者清醒时间和留观时间D组短于P组（P〈0.05）;D组术中呼吸抑制的发生率、肢动反应的发生率、术后不良反应的发生率低于P组（P〈0.05）。结论右美托咪定和丙泊酚分别复合瑞芬太尼,用于门诊无痛人流手术时,均能取得良好的麻醉效果。

In the outpatient painless artificial abortion,study the clinical effect of Dexmedetomidine and Propofol respectively combined with Remifentanil.【Methods】120 patients undergoing outpatient painless artificial abortion at selective time,18～40 years old,ASA grade Ⅰ~Ⅱ,was randomly divided into two groups,60 for each group.In group D,Dexmedetomidine combined with Remifentanil was used for anesthesia;and in group P,Propofol combined with Remifentanil was used.Recorded the HR,MAP,SpO 2 and Ramsay score at entering the operation room（T 0）,after inducing（T 1）,enlargement of cervical（T 2）,uterine curettage（T 3）,operation completed（T4） and 5 min after operation completed（T 5）;recorded the curettage（T 3）,operation completed（T 4） and 5 min after operation completed（T 5）;recorded the improved OAA/S score 5 min after the operation;recorded the time of sleeping,operation,regain consciousness and observation;recorded the occurrence of the respiratory depression and body response during the operation,the occurrence of shiver,nausea and other side effects after operation.【Results】T 4,the Ramsay score in Group D is higher than in Group P（P 0.05）;T 1 ～T 4,the SpO 2 in group D is higher than in Group P（P 0.05）;T 1 ～T 4,the MAP,HR in group D are lower than in group P（P 0.05）;the improved OAA/S score at 5 min after the operation in group D is higher than in group P（P 0.05）;the time of regain consciousness and observation in group D are shorter than in group P（P 0.05）;the occurrence of respiratory depression,body response during operation and side effect after operation in group D are lower than in group P（P 0.05）.【Conclusions】Dexmedetomidine and Propofol respectively combined with Remifentanil used in outpatient painless artificial abortion,both will get good anesthetic effect.