地佐辛与喷他佐辛在无痛人工流产术中的麻醉效果

Anesthesia Effect of Dezocine and Pentazocine in Painless Artificial Abortion

目的观察地佐辛和喷他佐辛在无痛人工流产（人流）术中的麻醉效果,为临床麻醉安全用药提供参考。方法择期全麻下行无痛人流手术的患者300例纳入研究,按照抽签法随机分为4组,A组（单纯丙泊酚组）;B组（丙泊酚联合芬太尼组）;C组（丙泊酚联合地佐辛组）;D组（丙泊酚联合喷他佐辛组）,每组75例。4组患者均根据术中情况适时追加丙泊酚1-1.5 mg·kg^-1维持麻醉效果。观察患者诱导前后、手术开始时、术中以及麻醉苏醒时心率（HR）、平均动脉压（MAP）、动脉血氧饱和度（Sp O2）和呼吸频率的变化,同时记录4组患者麻醉起效时间、苏醒时间、定向力恢复时间、丙泊酚用药量、术后疼痛评分以及不良反应的发生率。结果 4组患者手术过程中均能达到良好的麻醉效果,且用药起效时间差异无统计学意义（P〉0.05）;B、C、D组患者苏醒时间及定向力恢复时间明显短于A组（P〈0.05）;C、D两组丙泊酚用药量明显少于A、B两组（P〈0.05）;B、C、D组患者诱导后各时间点HR、MAP、Sp O2及呼吸频率的变化差异无统计学意义（P〉0.05）,但与A组比较各指标变化均较平稳（P〈0.05）;B、C、D组患者术中不良反应发生率明显低于A组（P〈0.05）;但C、D两组患者呼吸抑制和恶心、呕吐的发生率更加明显的低于A、B两组（P〈0.05）;术后B、C、D组患者疼痛VAS评分明显优于A组（P〈0.05）。结论地佐辛与喷他佐辛镇痛效果相当,应用于无痛人流术时能减少丙泊酚用量、缩短麻醉苏醒时间,同时不良反应少,可安全有效地用于临床麻醉。

Objective To observe the anesthesia effect of dezocine and pentazocine in painless artificial abortion,in order to provide a basis for safe use of anesthesia drug in clinical practice. Methods Totally,300 patients undergoing painless artificial abortion were included in this study.The patients were randomly divided into four groups： group A（ simple propofo）,group B（ propofol combined with fentanyl）,group C（ propofol combined with dezocine） and group D（ propofol combined with pentazocine）（ n = 75 each）.Four groups of patients were intravenously injected with propofol（ 1-1.5 mg·kg^-1） according to the situation in operation when necessary to maintain anesthesia effect. Heart rate（ HR）,mean arterial pressure（ MAP）,arterial oxygen saturation（ Sp O2） and respiratory frequency were observed and recorded before induction,after induction,at the beginning of the operation,during operation and anesthesia recovery. The onset time of anesthesia,the recovery time,the recovery time of orientation,the postoperative pain score and the incidence of adverse reaction of the four groups were recorded. Results All of the patients achieved good effects of anesthesia in operations. There was no significant difference in the onset time of anesthesia（ P〉0.05）.Awakening time and time of orientation recovery in groups B,C and D were significantly shorter than those in group A（ P〈0.05）.The dosages of propofol in group C and D were significantly less than those in group A and B（ P〈0.05）.The changes of HR,MAP,Sp O2 and respiratory frequency after induction were not significantly different in group B,C and D（ P 〉0.05）,but the changes were relatively stable as compared with group A（ P〈0.05）.The rates of adverse reactions in group B,C and D were significantly lower than that in group A（ P〈0.05）.The incidence rates of respiratory depression,nausea and vomiting in group C and D were significantly lower than those in group A and B（ P〈0.05）.The postoperative pain scores of VAS in group B,C and D were significantly lower than that of group A（ P〈0.05）. Conclusion The analgesia effects of dezocine and pentazocine are similar.Application of them can reduce the dosage of propofol and shorten the anesthesia awakening time in painless artificial abortion,at the same time they have less adverse reactions,and they are safe and effective to be used in clinical anesthesia.