丙泊酚配伍芬太尼、氯胺酮、地佐辛用于人工流产中的镇痛效果对比研究

Analgesic effect of propofol alone and joint use with fentanyl,ketamine and dezocine in artificial abortion

目的:对比研究丙泊酚单用及配伍芬太尼、氯胺酮、地佐辛在人工流产术中的镇痛效果及安全性。方法:将160例患者随机分为A、B、C、D四组,每组40例,A组患者单纯使用丙泊酚进行麻醉;B组患者使用丙泊酚配伍芬太尼进行麻醉;C组患者使用丙泊酚配伍氯胺酮进行麻醉;D组患者使用丙泊酚配伍地佐辛进行麻醉。观察并记录各组患者丙泊酚的总用量、唤醒时间、定向力恢复时间,以及患者呼吸抑制和体动反应发生情况,术中镇痛效果和术后下腹痛VAS评分。结果:唤醒时间和定向力恢复时间A组明显长于B、C、D组(P<0.05);术中镇痛效果B、C、D组明显优于A组,术后下腹痛VAS评分,D组明显优于其它各组(P<0.05)。在安全性方面,A组患者术中体动明显多于B、C、D组,而B、C组的呼吸抑制发生率明显高于A、D组(P<0.05)。结论:丙泊酚配伍地佐辛用于无痛人工流产,镇痛效果强,呼吸抑制率低,安全有效,值得临床广泛使用。

Objectives：To compare the effect and safety of propofol alone and joint use with fentanyl,ket-amine,and dezocine in artificial abortion.Methods：160 patients were randomly divided into group A,B,C,D, 40 cases in each group.Group A,B,C and D adopted propofol,propofol combined with fentanyl,propofol com-bined with ketamine and propofol combined with dezocine for anesthesia respectively.Total amount of propofol, wake-up time,orientation recovery time,and the respiratory depression and body dynamic response of each group were observed and recorded.Intraoperative analgesic effect and postoperative lower abdominal pain VAS were graded in each group.Results：As to wake-up time and orientation,recovery time,group A was significantly longer than group B,C,D （P〈0.05）;intraoperative analgesia effect of group B,C,D were obviously better than group A;postoperative lower abdominal pain VAS score of group D was better than the other groups （P〈0.05）.In terms of safety,body dynamic response of group A was significantly more than group B,C,D,while the incidence of respir-atory depression in group B,C was significantly higher than group A,D （P〈0.05）.Conclusions：For induced a-bortion,propofol combined with dezocine has strong analgesic effect with low respiratory depression.As a safe and effective method,it is worthy wide application in clinical practice.