芬太尼次髎穴注射对丙泊酚静脉麻醉无痛人工流产术效果影响研究

Influence of the clinical effect and adverse reaction of painless induced abortion with Fentanyl Ciliao point injection

目的探讨芬太尼不同给药方法对丙泊酚静脉麻醉无痛人工流产术效果的影响。方法将拟行无痛人工流产的早孕者150例随机分为3组,每组50例。Ⅰ组采用芬太尼次髎穴注射配合丙泊酚静脉麻醉,Ⅱ组采用芬太尼皮下注射配合丙泊酚静脉麻醉,Ⅲ组采用芬太尼静脉注射配合丙泊酚静脉麻醉。观察3组术中及术后收缩压(SBP)、心率(HR)、末梢血氧饱和度[Sp(O2)]变化及麻醉效果、麻醉剂用量、麻醉后苏醒时间、术后宫缩痛及不良反应发生情况。结果Ⅲ组术中SBP下降,HR减慢,与术前及Ⅰ组、Ⅱ组比较差异均有统计学意义(P均<0.05);Ⅲ组术中Sp(O2)显著低于Ⅰ组和Ⅱ组(P均<0.05);丙泊酚用量Ⅰ组明显少于Ⅱ组、Ⅲ组(P均<0.05);术后苏醒时间Ⅰ组明显短于Ⅱ组、Ⅲ组(P均<0.05);术后宫缩痛Ⅰ组明显轻于Ⅱ组、Ⅲ组(P均<0.05);麻醉效果Ⅰ级率Ⅰ组明显高于Ⅱ组、Ⅲ组(P均<0.05);Ⅲ组恶心呼吸抑制及咳嗽反射发生率均高于Ⅰ组、Ⅱ组(P均<0.05)。结论芬太尼次髎穴注射能显著提高无痛人工流产术的麻醉效果,减少或避免手术后宫缩痛及不良反应的发生,提高了无痛人工流产术的安全性。

Objective It is to explore the influences of Fentanyl by different administration methods on the effect of pain- less induced abortion. Methods 150 early pregnancy patients scheduled for painless artificial abortion were randomly divided into 3 groups with 50 cases in each group： Fentanyl Ciliao point injection combined with propofol venous anesthesia group （group Ⅰ ） , Fentanyl subcutaneous injection combined with propofol venous anesthesia group（ group Ⅱ） , and Fentanyl intrave- nous infusion combined with propofol venous anesthesia group （group Ⅲ ）. The changes of BP, HR, Sp（O2） were observed in the three group during and after operation, at the same time the effect of anesthesia was evaluated, postoperative uterine contraction pain and adverse reactions, the time of waking up after anesthesia and anesthetic dosage were recorded. Results Intraoperative BP decreased, HR slowed in group Ⅲ , compared with the preoperative in the same group, and in group Ⅰ, the differences were statistically significant （ P 〈0. 05 ）. Intraoperative Sp （ O2 ） in group Ⅲ was significantly lower than that in group Ⅰ and group Ⅱ （ P 〈0.05 ）. The dosage of propofol in group Ⅰ was significantly less than that in group Ⅱ and group Ⅲ （P 〈 0.05）. The recovery time after operation in group Ⅰ was significantly shorter than that in group Ⅱ and group Ⅲ （P 〈 0. 05 ）. VAS scores of postoperative uterine contraction pain in group Ⅰ were less than that in group group lI and group Ⅲ（P 〈 0. 05 ）. The rate of anaesthesia effect Ⅰ level in group I was higher than that in group Ⅱ and group Ⅲ （ P 〈 0.05）. Inhibition of respiration and cough reflex occurrence in Group Ⅲ were higher than that of group Ⅰ , group Ⅱ , the difference was statisti- cally significant （P 〈 0.05）. Conclusion Fentanyl Ciliao point injection can significantly improve the effect of anesthesia in painless artificial abortion, reduce or avoid operation uterine contraction pain and the incidence rate of adverse reactions, im- prove the safety of painless induced abortion.