稀释氧化亚氮和丙泊酚在无痛人工流产术中的应用研究

Application Research of Diluted Nitrous Oxide and Propofol on the Painless of Artificial Abortion

目的比较稀释氧化亚氮(H2O)吸入与丙泊酚静脉麻醉在无痛人工流产术中的镇痛效果与不良反应。方法将80例因避孕失败要求终止妊娠的早孕女性随机分为稀释(N2O)组和丙泊酚组,每组40例,两组在年龄、孕产次、受教育程度等方面差异无统计学意义。比较两组药物的镇痛效果、医生和患者对镇痛效果是否满意及患者发生不良反应的差异。结果稀释N2O组患者术中及术后疼痛程度分级在0级者分别为26例和30例,丙泊酚组的患者分别为33例和34例,两组在术中及术后的镇痛程度差异均无统计学意义(P>0.05);就术中医生对镇痛效果是否满意而言,稀释N2O组有26例达到满意,丙泊酚组有34例,比较后两组差异有统计学意义(P<0.05);术后对医生和患者对于两组药物的镇痛效果是否满意分别进行比较,差异均无统计学意义(P>0.05);患者术中或术后发生的不良反应主要有恶心呕吐、术后腹胀及人工流产综合征等,两组比较后差异无统计学意义(P>0.05)。结论与临床上广泛应用的丙泊酚静脉麻醉效果相比,稀释氧化亚氮同样具有较好的镇痛效果,不良反应少,医生和患者对其镇痛效果均较满意,且操作简单、适合应用于无痛人工流产术,尤其可在基层医院进行推广。

Objective To compare the analgesic effect and adverse effect of diluted nitrous oxide and protofol on the pain of artificial abortion. Method 80 early-pregnant women were recruited and randomly divided into diluted nitrous oxide group and protofol group,with 40 patients each group. There was no significant difference in age,maternity and educational level between the two groups. The analgesic effects,satisfaction of doctors and patients on the analgesic effect and adverse reactions of two groups were compared. Result There were 26 patients and 30 patients reporting no pain during and after the surgery in the group of diluted nitrous oxide group,and there were 33 cases and 34 cases reporting no pain during and after the surgery in propofol group. There was no significant difference in the pain degree between the two groups（ P 〉 0. 05）. Doctors were satisfactied with 34 cases in Nitrous Oxide group and 26 cases in propofol group during the surgery. The difference of satisfaction in two groups was significant（ P 〈0. 05）. There was no difference between the two groups on doctor and patient satisfaction on the analgesic effect after surgery（ P 〉 0. 05）. A few adverse reactions was found in two groups,such as postoperative abdominal distension,nausea,vomiting and other abortion syndrome. There was of no significant difference between the two groups in terms of adverse reaction（ P 〉 0. 05）. Conclusion Compared with the effect of propofol intravenous anesthesia,the dilution of Nitrous Oxide has good analgesic effect,leading less adverse reaction. And it is easy to be operated. So,it can be used for painless artificial abortion,especially in primary hospital.