阿芬太尼复合丙泊酚用于绝经妇女取环术

Alfentanil complex with propofol for removing IUD in menopausal women

目的 观察阿芬太尼复合丙泊酚用于绝经妇女取环术的麻醉效果。方法 将要求取环的绝经妇女60例随机分为3组,每组20例：A组丙泊酚＋阿芬太尼组,B组丙泊酚＋芬太尼组,C组丙泊酚组。A组先缓慢静脉推注阿芬太尼5μg kg-1,5 min后缓慢静脉推注丙泊酚1.5 mg kg-1;B组先缓慢静推芬太尼1μg kg-1,5 min后缓慢静脉推注丙泊酚1.5 mg kg-1;C组缓慢静脉推注丙泊酚1.5 mg kg-1,丙泊酚静脉注射速率均为100 mg min-1。待患者安静入睡睫毛反射消失后开始取环,如术中出现体动追加异丙酚20～50 mg,观察并记录3组患者生命体征变化、不良反应、体动反应及丙泊酚总用量、宫颈软化程度、取环成功率。结果 患者术中,A组平均动脉压、血氧饱和度显著高于B、C组（P〈0.05）;A、B 2组体动反应及丙泊酚总用量显著低于C组（P〈0.05）;A、B组宫颈软化程度均高于C组（P〈0.05）,A组清醒时间少于B、C组（P〈0.05）。结论 阿芬太尼复合丙泊酚用于绝经妇女取环无呼吸暂停及循环抑制,安全系数更高,且清醒时间更短,更适合门诊短小手术的麻醉。

Objective To observe the anesthesia effect of alfentanil complex with propofol on removing IUD in menopausal women. Methods A total of 60 females who voluntarily requested for removal of IUD, were randomly divided into 3 groups： group A, alfentanil complex with propofol, group B fentanil complex with propofol and group C propofol. Group A were administered alfentanil 5 μg · kg- 1 intravenously first and 5 min later followed by 1.5 mg · kg- 1 propofol. Group B were given fentany 1 μg · kg- 1 slowly first and after 5 min with 1.5 mg · kg- 1 propofol intravenously. Group C were given propofol 1.5 mg · kg- 1 intravenously. The speed of intravenous injection of propofol was 100 mg ·min- 1. IUD removal began after eyelash reflex disappeared. During the removal, if there was body movement reaction, propofol（20- 50） mg was added in the 3 groups. The vital signs, adverse effect, body movement reaction, propofol dosage, softening degree of the cervix, and success rate of IUD removal were recorded. Results When the eyelash reflex disappeared, the mean arterial pressure and SPO2 in group A were higher than those in group B and C（P 0.05）. The body movement reaction, and propofol dosage in group A and B were less obvious and lower than group C（P 0.05）. The softening degree of the cervix in group A and B was higher than that in group C（P 0.05）.The awake time of group A was shorter than group B and C（P 0.05）. Conclusion Fentanil complex with propofol for removing IUD show no apnea and non-cyclic inhibition, shorter awake time, more suitable for anesthesia outpatient surgery.