不同剂量舒芬太尼复合丙泊酚在人工流产手术中的应用

Propofol Combined with Different Doses of Sufentanil in Induced Abortion Operation

目的 研究静脉注射不同剂量舒芬太尼复合丙泊酚在人工流产手术中的应用效果.方法 120例ASA Ⅰ～Ⅱ级择期行人工流产手术患者,随机分为4组,其中观察组分别应用0.05 μg/kg（S1组）、0.1μg/kg（S2组）、0.15 μg/kg（S3组）舒芬太尼复合丙泊酚;对照组（C组）单纯应用丙泊酚.用药期间观察MAP、HR、SpO2,记录用药情况、意识消失时间、意识和定向力恢复时间、术后宫缩痛VAS评分和发生率.结果 S1组和C组MAP、HR、SpO2均稍有下降,但无显著性差异（P＞0.05）;S2组MAP无明显变化、HR和SpO2均下降（P＜0.05）;S3组MAP、HR、SpO2均显著下降（P＜0.01）;S1组丙泊酚用量、意识恢复时间、定向力恢复时间与C组比无显著性差异（P＞0.05）;S2组和S3组丙泊酚用量、意识恢复时间、定向力恢复时间均明显低于C组（P＜0.01）;术后宫缩痛S2组和S3组绝大多数患者（90％） VAS＜3分,S2组和S3组术后宫缩痛发生率明显低于C组（P＜0.01）.结论 静脉注射适当剂量的舒芬太尼（0.1μg/kg）复合丙泊酚不仅可减少丙泊酚的用量,有效地抑制或减轻了患者术后宫缩痛,且不影响清醒质量,提高了患者的舒适度.

Objective To explore the effects of intravenous injection of propofol combined with different doses of sufentainl in induced abortion operation. Methods 120 patients of ASA I - Ⅱ undergoing induced abortion operation were randomly assigned into 4 groups. Patients received the same doses of propofol combined with different doses sufentanil 0.05 μg/kg（ group S1 ）, 0.1μg/kg （ group μ2 ） and 0. 15 μg/kg （ group S3 ）. Patients in the control group （group C） received propofol only. MAP, HR and SpO2 were observed during medication. Medication, time of uncon- sciousness,consciousness recovery time, orientation recovery time, VAS score and incidence rate of contractions pain after operation. Results MAP, HR and SpO2 in group S1 and group C decreased slightly,but there was no significant difference（P 〉 0.05 ）. MAP in group S2 had no obvious change. HR and SpO2 both decreased （P 〈 0.05 ）. MAP, HR and SpO2 in group S3 all decreased significantly（ P 〈0.01 ）. There was no significant difference in dose of propofol, consciousness recovery time and orientation recovery time between group S1 and group C（ P 〉 0.05 ）. Dose of propofol, consciousness recovery time and orientation recovery time in group S2 and group S3 were lower than those in group C（P 〈0.01 ）. VAS score was less than 3 in 90% patients with contractions pain after operation in group S2 and S3. Occurrence rate of contractions pain after operation in group S2 and S3 was obviously lower than those in group C （ P 〈 0.01 ）. Conclusion Propofol combined with sunfentanil （0. 1 μg/kg）can reduce the doses of propofol and safely relieve contractions pain after operation without affecting consciousness quality, which can improve comfort level of patients.