不同麻醉药物在人工流产术麻醉时的效果及对呼吸循环的影响

Study on the Effect of Different Anesthetic Drugs in Abortion Anesthesia and Their Impact on Respiration and Circulation

目的探讨不同麻醉药物在人工流产术麻醉时的效果及其对呼吸循环的影响。方法选择2012年3月至2013年3月南宁市第六人民医院收治的拟行人工流产术的患者248例,采用随机数字表法分为四组,分别采用单纯丙泊酚、丙泊酚复合芬太尼、丙泊酚复合瑞芬太尼、丙泊酚复合氯胺酮麻醉,然后对四组患者的镇痛效果、各组麻醉药物的总用量及对呼吸、循环系统的影响进行评价。结果四组人流患者术中及术后镇痛效果比较,差异具有统计学意义(H=16.944,24.072,P<0.05)。丙泊酚复合瑞芬太尼麻醉组麻醉药物用量显著地少于其他三组(P<0.05),四组患者术前、术中、术后的心率和血氧饱和度组间及组间·不同时点间比较无统计学意义(P>0.05),不同时点间比较具有统计学意义(P<0.05);四组患者术中心率明显地低于术前及术后,术前、术后比较差异不显著;患者术前血氧饱和度明显地高于术中及术后,术中、术后比较变化不显著。结论丙泊酚复合麻醉是较理想的麻醉方法,建议根据患者的情况选择不同的复合麻醉药物。

Objective To investigate the effect of different anesthetic drugs in abortion anesthesia and their impact on respiration and circulation. Methods A total of 248 patients admitted in Nanning Sixth People＇s Hospital for artificial abortion operation from Mar. 2012 to Mar. 2013 were selected and divided into four groups by random number table method. Respectively,patients in four groups received simple propofol, mixture of propofol and fentanyl, mixture of propofol and remifentanil, mixture of propofol and ketamine for anesthesia. The analgesic effect, total dosage of anesthetic drugs for patients in each group and their impact on the respiratory and circulatory system were evaluated. Results The differences of intraoperative and postoperative analgesia effects of the four groups were statistically significant （ H = 16. 944,24. 072, P 〈 0.05 ）. The dosage of mixture of propofol and remifentanil was the least among the four groups（ P 〈 0.05 ）. The preoperative,intraoperative and postoperative interclass comparison and interclass · different-time-points comparison of heart rate（HR） and degree of blood oxygen saturation（ SpO2 ） among the four groups and had no significant statistical difference （P 〉 0.05 ）, while there was significant statistical difference in different time points （ P 〈 0.05 ）. The intraoperative heart rates of the four groups were significantly lower than the preoperative and postoperative HRs, and there was no significant difference between the preoperative and postoperative data. Preoperative degrees of blood oxygen saturation of the four groups were significantly higher than the intraoperative and postoperative SpO2 s, and there was no significant difference between intraoperative and postoperative data. Conclusion Propofol anesthesia is an ideal anesthesia method. It is recommended that mixture of different anesthesia drugs can be chosen according to the patient＇s condition.