咪达唑仑与舒芬太尼复合丙泊酚用于无痛人工流产术的临床分析

Analysis of midazolam and sufentanil combined with propofol for painless abortion

目的比较咪达唑仑与舒芬太尼复合丙泊酚在无痛人工流产术中应用的临床效果、安全性及剂量。 方法随机选取自愿进行无痛人工流产手术患者各200例进行研究。玉溪市人民医院使用2 mg咪达唑仑（A组）复合丙泊酚麻醉，楚雄彝族自治州人民医院使用10 μg舒芬太尼（B组）复合丙泊酚麻醉。咪达唑仑和舒芬太尼提前3 min静脉滴注，然后再静脉滴注丙泊酚（10 mg/s）。比较两组丙泊酚注射痛语言等级评定量表评分（VRS评分）、麻醉不良反应[呛咳、恶心呕吐、呼吸抑制、显著低血压（血压下降〉基础血压30%）、心动过缓]、丙泊酚总量、苏醒时间、定向力恢复时间、离院时间和醒后5 min宫缩痛视觉模拟数字评分（VAS评分）。 结果A组VRS评分、丙泊酚总量、苏醒时间、定向力恢复时间、离院时间和醒后5 min宫缩痛VAS评分均明显大于B组（P〈0.01）。两组麻醉不良反应中呛咳、恶心呕吐、心动过缓发生率比较差异未见统计学意义（P〉0.05），而呼吸抑制和显著低血压发生率A组高于B组（P〈0.05）。 结论丙泊酚复合小剂量舒芬太尼用于无痛人工流产术，患者呼吸循环稳定，效果优且不良反应少，术后清醒快，患者满意率高，麻醉更安全。

ObjectiveTo compare the clinical effect, safety and dose of midazolam and sufentanil combined with propofol in painless abortion. MethodsA total of 200 patients with painless abortion were selected. The people’s hospital of Yuxi used 2 mg midazolam （group A） combined with propofol anesthesia, and the people’s hospital of Chuxiong Yi autonomous prefecture used 10 μg sufentanil （group B） combined with propofol anesthesia. Midazolam and sufentanil 3 min ahead of the infusion, and then intravenous injection propofol （10 mg/s）. The propofol injection pain rating scale （VRS score）, adverse effects of anesthesia [cough, nausea and vomiting, respiratory depression, significant hypotension （blood pressure drop〉 basal blood pressure 30%）, bradycardia], propofol volume, recovery time, orientation recovery time, hospital discharge time and visual analogue digital score （VAS score） of uterine contraction in 5 min after awakening were compared. ResultsThe VRS scores, propofol volume, recovery time, orientation recovery time, hospital discharge time and VAS score of uterine contraction in 5 min after propofol injection in group A were significantly higher than those in group B （P〈0.01）. The incidence of cough, nausea, vomiting and bradycardia in the two groups were not significantly different （P〉0.05）. The incidence of respiratory depression and significant hypotension was higher in group A than those in group B （P〈0.05）. ConclusionsPropofol combined with low-dose sufentanil for painless abortion has stable respiration and circulation, excellent results and less adverse reactions, and it has quick postoperative awake, high patient satisfaction, more secure anesthesia.