哌替啶复合氟哌利多在无痛人流术中的应用

Use of Pethidine Combined with Droperidol in Painless Artificial Abortion

目的观察哌替啶复合氟哌利多在无痛人流中的麻醉效果和安全性。方法 400例无痛人流的早孕患者根据麻醉用药的不同分为2组,A组152例采用丙泊酚麻醉,B组248例采用哌替啶复合氟哌利多麻醉,2组患者均在静脉注射药物前应用1%利多卡因行宫颈旁阻滞。比较2组收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)、呼吸频率(respiratory rate,RR)、脉搏血氧饱和度(pulse oxygen saturation,Sp O2)、Ramsay镇静评分、麻醉起效时间、术后离床时间、术后留观时间、镇痛效果和术后恶心呕吐等不良反应的发生情况。结果麻醉后A组收缩压、舒张压及呼吸频率显著低于B组[(90.3±10.7)mm Hg vs.(100.6±12.0)mm Hg,t=-8.677,P=0.000;(69.9±7.5)mm Hg vs.(78.8±10.5)mm Hg,t=9.119,P=0.000;(16.7±2.7)次/min vs.(18.6±3.2)次/min,t=-6.107,P=0.000]。A组镇静评分显著高于B组[(6.0±0.1)分vs.(3.4±1.4)分,t=22.850,P=0.000];A组术后离床时间和术后留观时间显著长于B组[(11.0±3.3)min vs.(3.5±1.6)min,t=30.442,P=0.000;(118.8±1.1)min vs.(30.5±2.9)min,t=359.722,P=0.000]。结论复合应用宫颈局部麻醉,2种麻醉方法均可满足手术需要,但哌替啶复合氟哌利多的麻醉效果更符合基层医院的实际情况。

Objective To evaluate anesthetic effects and safety of pethidine combined with droperidol in painless artificial abortion. Methods A total of 400 patients with early pregnancy were divided into two groups： the group A（ n = 152） was given propofol anesthesia; the group B（ n = 248） was given pethidine combined with droperidol anesthesia. Both groups of patients underwent 1% lidocaine paracervical block before intravenous injection of anesthetic drugs. The systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,heart rate（ HR）,respiratory rate（ RR）,pulse oxygen saturation（ Sp O2）,Ramsay sedation score,onset time for anesthesia,postoperative off-bed time,postoperative hospital stay,the analgesic effects,and postoperative nausea and vomiting and other adverse reactions were compared between the two groups. Results After anesthesia,the systolic and diastolic blood pressure and respiratory rate were significantly lower in the group A than the group B [（ 90. 3 ± 10. 7） mm Hg vs.（ 100. 6 ±12. 0） mm Hg,t =- 8. 677,P = 0. 000;（ 69. 9 ± 7. 5） mm Hg vs.（ 78. 8 ± 10. 5） mm Hg,t = 9. 119,P = 0. 000;（ 16. 7 ± 2. 7）times / min vs.（ 18. 6 ± 3. 2） times / min,t =- 6. 107,P = 0. 000]. The sedation score was significantly higher in the group A than the group B [（ 6. 0 ± 0. 1） points vs.（ 3. 4 ± 1. 4） points,t = 22. 850,P = 0. 000]. The group A had significantly longer postoperative off-bed time and postoperative hospital stay than the group B [（ 11. 0 ± 3. 3） min vs.（ 3. 5 ± 1. 6） min,t = 30. 442,P =0. 000;（ 118. 8 ± 1. 1） min vs.（ 30. 5 ± 2. 9） min,t = 359. 722,P = 0. 000]. Conclusion With composite application of cervical local anesthesia,both anesthetic methods can meet the needs of surgery,but pethidine combined with droperidol is more suitable for grass-roots hospitals.