异丙酚静脉麻醉人工流产的临床研究

The Clinical Investigation of Intravenous Anesthesia with Propofol in Suction Termination of Pregancy

目的 :评价异丙酚静脉麻醉人工流产的效应。方法 :16 0 0例ASAⅠ～Ⅱ、妊娠 1～ 3月孕妇 ,80 0例自愿实行全麻人工流产者为治疗组 ,另 80 0例自愿无麻醉人工流产者为对照组。治疗组采用两次推注给药法 ,首次给药至深镇静 ,1 5～ 2分钟后再次追加 5 0 %诱导量。观察诱导剂量、诱导过程术中HR、BP、SpO2 变化、恢复时间、副作用、患者满意程度及对照组VAS评分。结果 :两组平均手术时间为 5 2 8～ 5 44分钟 ,治疗组异丙酚用量 187 40± 32 18mg ;治疗组术中MAP下降大于 2 0 %的患者为 13 % ,对照组为 39% ;治疗组HR减慢超过 2 0 %为 7 9% ,对照组为 39% ;治疗组恶心和呕吐率分别为 2 1%和 1 9% ,对照组为 2 3 9%和 6 1% ,均有非常显著差异 (P <0 0 1)。对照组 80 1%患者出现人流综合症 ,VAS评分 7 1分 ,而治疗组满意率为 99 4% ,无不满意者 ,麻醉后清醒和定向力恢复迅速。结论 :异丙酚可满足人工流产手术的需要。异丙酚静脉麻醉用于人工流产明显减低副作用 。

Objective:To evaluate the effect of propofol intravenous anesthesia in suction termination of pregancy.Methods: 1?600 ASAⅠ Ⅱ pregant women in 1 3months undergoing suction termination of pregancy received intravenous anesthesia with propofol(group Ⅰ, n= 800) or without anesthesia (group Ⅱ, n= 800).Anesthesia was induced using propofol 1 2mg/kg to the level of deep sedation,one to two min later,another bolus dose of propofol 0 5 1 0mg/kg was used.Induction dose,induction time,HR,BP,SpO 2,recovery time,side effects and patient satisfaction were assessed.Results:Baseline variables did not differ between two groups.The average surgical time was 5 28 5 44min. In group Ⅰ,dosage of propofol were 187 40±32 18mg.GroupⅡ had more decreased BP than group I(39% vs 13%).The HR was significantly decreased in group I compared to that in groupⅡ(7 9% vs 39%).Similarly,the incidences of nausea and vomiting (23 9% vs 2 1%,6 1% vs 19%) were also significantly reduced in groupⅠ.The rate of patient satisfaction was high(99 4%) in the groupⅠ.Conclusion:Propofol anesthesia effectively reduces side effect of suction termination of pregancy and nearly all the patients were satisfied with propofol anesthesia.