丙泊酚手控和靶控输注在无痛人流手术麻醉中的临床比较分析

Clinical Comparative Analysis of Manually Controlled and Target-con-trolled Infusion of Propofol for the Anesthesia of Painless Artificial Abortion

目的比较丙泊酚靶控输注静脉给药与手控静脉给药麻醉对无痛人流手术的影响。方法将300例人流手术者随机分为两组,观察组：靶控输注泵推注丙泊酚,靶质量浓度设定为6~7 mg/L,维持时靶质量浓度设定为4~5 mg/L,手术结束时停止输药;对照组：手控静脉推注给药,丙泊酚诱导量2~2.5 mg/L,手术期间追加丙泊酚50 mg左右;分别观察两组诱导、苏醒时间、总药量、麻醉效果及诱导前后平均动脉压、心率、动脉血氧饱和度的变化。结果观察组诱导、苏醒时间、用药量均少于对照组;差异有统计学意义（P〈0.05）;两组诱导后平均动脉血压、心率、血氧饱和度均低于术前差异有统计学意义（P〈0.05）;对照组下降更严重;麻醉效果观察组优于对照组,差异有统计学意义（P〈0.05）。结论靶控输注丙泊酚麻醉用于人工流产手术可减少麻醉用药量,缩短麻醉诱导、苏醒时间,具有较好的麻醉效果。

Objective To compare the effect between manually controlled and target-controlled infusion of propofol for the anesthesia of painless artificial abortion. Methods 300 cases underwent artificial abortion were randomly divided into two groups, the observation group and the control group. In the observation group, the anesthesia was induced dosage at 6~7 mg·L-1 by targetcontrolled infusion of propofol, maintained at 4~5 mg·L-1, stopped injecting when the operation was end. The control group was given manually controlled infusion of propofol, induced dosage at 2~2.5 mg·L-1, propofol could be added about 50 mg during the operation. The induction time, recovery time, the total dose of propofol and anesthetic effects in 2 groups were compared. Mean arterial pressure（MAP）, HR, arterial oxygen saturation（Sa O2） were recorded before and after induction. Results The induction time,recovery time and total dosage of propofol in the observation group were all less than those in the control group, the difference was statistically significant（P〈0.05）. MAP, HR and Sa O2 after induction in two groups were all lower than before induction, the difference was statistically significant（P〈0.05）, especially in the control group. The anesthesia effect was significantly better in the observation group, the difference was statistically significant（P〈0.05）. Conclusion Target-controlled infusion of propofol in painless artificial abortion can decrease the dose requirement of propofol, shorten the time of induction and recovery and increase the anesthetic effect.