羟考酮、利多卡因复合丙泊酚、依托咪酯用于无痛人流的疗效观察

The clinical observation of oxycodone,lidocaine combined with propofol and etomidate for painless artificial abortion

目的探讨盐酸羟考酮注射液复合利多卡因、丙泊酚及依托咪酯用于人工流产术的临床效果。方法选取自愿施行无痛人流术的孕妇100例,随机分为两组,观察组(O组)用盐酸羟考酮注射液+利多卡因+丙泊酚+依托咪酯,对照组(F组)用芬太尼+丙泊酚+依托咪酯麻醉,观察两组孕妇的心率、平均动脉压、血氧饱和度、意识消失及恢复时间、注射痛、不良反应发生情况、术后宫缩痛及术前和术后30 min血浆肾上腺素和去甲肾上腺素水平。结果两组孕妇意识消失、恢复时间及血流动力学变化、术中及术后不良反应情况比较差异无统计学意义(P>0.05);但两组孕妇注射痛及术后宫缩痛发生率比较,O组优于F组(P<0.05)。术后30 min O组肾上腺素和去甲肾上腺素水平明显低于F组。结论盐酸羟考酮注射液复合利多卡因、丙泊酚及依托咪酯用于无痛人流术,麻醉效果确切,减少注射痛及术后宫缩痛,患者满意度高,是一种较理想的麻醉方法。

Objective To investigate the effect of oxycodone hydrochloride injection combined with lidocaine,propofol and etomidate on painless induced abortion. Methods 100 early pregnancy women underwent painless induced abortion were randomly divided into two groups： observation group using oxycodone hydrochloride injection combinedwith lidocaine,propofol and etomidate for intravenous anesthesia,and control group receiving fentanyl injection combined propofol and etomidate. The heart rate（ HR）,mean artery pressure（ MAP）,pulse oxygen saturation（ SpO_2）,consciousness extinction time and recovery time,injection pain,pain of uterus contraction of post-operation,side effect of two groups were recorded. Plasma concentrations of adrenaline and noradenaline were measured. Results The consciousness extinction time and recovery time,MAP,HR,SpO_2 and side effect had no statistical difference between two groups（ P〉0. 05）; the adrenaline and noradenaline concentrations in group O were lower than that in group F（ P〈0. 05）. Conclusion Oxycodone hydrochloride injection combined with lidocaine,propofol and etomidate used in painless induced abortion including many advantages,such as the exact effect of anesthesia,reducing injection pain and postoperative pain,is an ideal method for aesthesia in painless.