地佐辛复合丙泊酚在无痛人工流产术的应用

Application of dezocine combined with propofol in painless artificial abortion

目的探讨地佐辛复合丙泊酚在无痛人工流产术中的麻醉效果和安全性。方法将门诊行人工流产术的200例患者随机分成地佐辛复合丙泊酚组(A组)和单用丙泊酚组(B组)两组,观察两组丙泊酚用量、手术结束至睁眼时间、定向力恢复时间、呼吸抑制(Sp O2<92%或呼吸暂停15s)及恶心、呕吐等不良反应的发生率,记录患者麻醉前5 min(T0)、睫毛反射消失时(T1),扩宫颈时(T2)、吸刮子宫内膜时(T3)、呼之能睁眼时(T4)平均动脉压(MAP)、心率(HR)、呼吸(RR)的变化;记录患者术后宫缩痛的发生情况。结果 A组丙泊酚用量明显低于B组。A组手术结束至睁眼时间、定向力恢复时间明显短于B组。A组呼吸抑制及恶心呕吐等不良反应的发生率显著低于B组;2组比较,差异有统计学意义(P<0.05),A组患者术中血流动力学稳定。结论地佐辛复合丙泊酚静脉麻醉较单用丙泊酚麻醉血流动力学更平稳。可明显缩短患者苏醒时间及定向力恢复时间,减少术后不良反应发生率及宫缩痛,提高患者的安全性和舒适度。

Objective To investigate the efficacy and safety of dezocine during anesthesia in painless induced abortion combined with propofol.Methods A total of 200 outpatients requiring painless artificial abortion in our hospital from June 2013 to December 2013 were ran-domized into two equal groups.One group was given dezocine combined with propofol （group A）, and the other given propofol （groupB）.The dosage of propofol, eye openning time, recovery time, inhibition of respiration （spo2〈92%or apnea 15s） and the incidence of adverse reac-tions, such as nausea and vomiting were observed , the variables of MAP, HR and RR were continuously recorded： 5min before anesthesia （ T0 ） , loss of eyelash reflex （ T1 ） ,when the cervix was expanded （ T2 ） , Suction curettage of endometrium （ T3 ） and duration of opening eyes on verbal command , the uterine contraction pain of the patient was also recorded after operation .Results The dosage of propofol was significantly lower , eye openning time and recovery time in group A were shorter and the incidence of adverse reactions , such as nausea and vomiting and in-hibition of respiration was significantly lower in group A than in group B , hemodynamics of patients in group A was stable .Conclusion The he-modynamics of using dezocine combined with propofol intravenous anesthesia was more stable than only using propofol .And it can shorten eye openning time and recovery time , reduce the incidence of adverse reactions after operation and uterine contraction pain , and improve the pa-tient’ s safety and comfort .