七氟烷或丙泊酚联合舒芬太尼用于无痛人流的比较

Comparison of Sevoflurane or propofol combined with sufentanil in painless artificial abortion

目的观察七氟烷或丙泊酚联合小剂量舒芬太尼对无痛人流患者的影响。方法150例早孕患者，随机分成丙泊酚静脉组（P组）和七氟烷吸入组（S组），其中七氟烷吸入组按照诱导方式不同又分为s。和S。组，三组分别复合舒芬太尼5μg（SA1、SB1、P1）和7．5¨g（SA2：、SB2、P2）。连续监测患者的平均动脉压（MAP）、血氧饱和度（SpO2）、心率（HR）及脑电双频指数（BIS）值，并记录诱导时间、手术时间、唤醒时间和定向力恢复时间、离室时间、异丙酚的总用量、患者体动、呼吸抑制、术中使用麻黄素及术后宫缩痛等情况。结果与SA1组相比，SB1、SB2两组患者诱导时间延长、P1、P2两组唤醒时间、定向力恢复时间和患者离室时间均明显延长（P〈0．05，P〈0．01）；相比SB1组，SA1和SA2组呼吸抑制发生率及术中麻黄素使用率明显升高（P〈0．05）。结论七氟烷或丙泊酚联合小剂量舒芬太尼均可安全、有效地用于无痛人流手术的麻醉，但各有优缺点。七氟烷较丙泊酚麻醉，苏醒更快更完全，其中复合始浓度为2．5％，术中再增加吸入浓度的七氟烷麻醉虽诱导更平稳，但诱导时间较长；而用8％诱导，1．5％-2％术中维持时应当注意加强麻醉期间循环和呼吸方面的管理。

Objective To investigate the effect of sevoflurane or propofol combined with low dose sufentanil on painless patients. Meth ods A total of 150 early-pregnant women were randomly divided into propofol group （P group） and sevoflurane group （S group） ,which was divided into SA and SB groups according to sevoflurane inhalation induction in different ways. Three groups were combined with sufen- tanil 5 μg（ SA1, SB1, P1 ） and 7.5 p,g （ SA2, SB2, P2 ）＂ MAP, SpO2, HR and BIS were monitored consecutively ; induction time, operation time, awake time, orientation recovery time, discharge time,the general usage of propofol, patients＇ body motion, respiratory depression , intraoperative use of ephedrine and postoperative uterine contraction pain were observed. Results Compared with group SA1, the induc tion time of group SB1 and Sa2were prolonged,the awake time, orientation recovery time and discharge time of group P1 and P2were signifi cantly increased （P 〈 0.05, P 〈 0.01 ）. The incidence of respiratory depression and intraoperative use of ephedrine of group S Al and SA2 were significantly higher than those in group SB1. Conclusions Although both sevoflurane and propofol combined with low dose sufen tanil can be used safely and effectively in painless artificial abortion. They have their own advantages and disadvantages. Compared with propofol,anesthesia with sevoflurane recovered faster and more completely, of which compound beginning concentration was 2.5%. The increase in the concentration of sevoflurane inhalation during surgery was more stable in induction, but the induction time was longer, while during anesthesia with the induction of 8%, 1.5% - 2% to maintain,we should pay attention to strengthening the management of circulatory and respiratory systems.