丙泊酚复合舒芬太尼、瑞芬太尼、芬太尼在无痛人流中应用效果的对比观察

Effect of propofol combined with sufentanil,remifentanil and fentanyl on painless abortion

目的观察比较丙泊酚分别复合舒芬太尼、瑞芬太尼、芬太尼静脉麻醉在无痛人工流产手术麻醉中的效果及安全性。方法将92例人流手术患者随机分为3组。S组31例,采用丙泊酚复合舒芬太尼麻醉;R组31例,采用丙泊酚复合瑞芬太尼麻醉;F组30例,采用丙泊酚复合芬太尼麻醉。分别记录三组患者麻醉前后、术中及术后MAP、HR、SpO2,记录三组患者丙泊酚用量、清醒时间,并采用视觉模拟评分(VAS)对三组患者清醒时及术后1 h疼痛程度进行评分,严密观察并记录三组患者不良反应发生情况。结果麻醉后,三组患者MAP、HR、SpO2均降低,R组SpO2明显低于其他两组。R组丙泊酚用量最小;S组清醒后1 h VAS评分最低。三组患者清醒时间、清醒时VAS评分差异无统计学意义。三组患者一般体动、严重体动、低血压、心动过缓发生率差异无统计学意义。与S组、F组相比,R组低氧血症发生率最高(25.81%)。结论舒芬太尼、瑞芬太尼、芬太尼复合丙泊酚用于无痛人流手术的麻醉镇痛效果显著,安全性高,但舒芬太尼复合丙泊酚术中生命体征较平稳、术后恢复快,配伍效果最佳。

Objective To observe the effect of propofol combined with sufentanil, remifentanil, fentanyl intravenous anesthesia on painless abortion. Methods 92 abortion patients were randomly divided into 3 groups. Group S （n = 31 ）received propofol combined with sufentanil anesthesia; group R （n = 31 ）received propofol combined with remifentanil ; group F （ n = 30 ） received propofol combined fentanyl. The MAP, HR, SpO2 , dose of propofol, awake time, and the visual analog scale （ VAS ） score were recorded at different time points. The adverse reactions were observed closely. Results After anesthesia, The MAP, FIR, SpO2 of the three groups decreased significantly, and SpO2 in group R was significantly lower than the other two groups. The dose of propofol in group R was less than the other two groups;VAS score in group S was the lowest. There was no significant difference in awake time and VAS scores at the time of awake among the three groups. No significant difference was found in body movement, severe body movement, hypotension,bradycardia among the three groups. The occurrence rate of hypoxemia in group R was the highest （25.81% ）. Conclusion Sufentanil, remifentanil, fentanyl combined propofol for painless abortion has good narcotic and analgesic effect with high security, but sufentanil combined propofol can provide more stable vital signs with rapid postoperative recovery, it can be regarded as the best compatibility.