丙泊酚复合纳布啡在无痛人流中的应用效果

Effect of propofol combined with nalbuphine applied to painless abortion

目的观察丙泊酚复合纳布啡静脉麻醉在无痛人流中的应用效果和安全性。方法将60例行无痛人流术患者随机分为观察组与对照组,每组30例。观察组患者采用丙泊酚复合纳布啡麻醉,对照组患者采用丙泊酚复合舒芬太尼麻醉。记录两组患者术前、术始、术毕、术毕5 min及术毕10 min时的平均动脉压(MAP)、心率、RR及动脉氧饱和度(SpO_2)、苏醒时间、苏醒后5、15、30、60 min时疼痛视觉模拟量表(VAS)评分、丙泊酚用量及术后60 min内不良反应发生情况。结果两组的MAP、心率、RR、SpO_2水平及VAS评分比较,差异均无统计学意义(均P>0.05),两组的MAP、心率、RR水平及VAS评分均有随时间变化的趋势(均P<0.05),两组的SpO_2水平均无随时间变化的趋势(均P>0.05),分组与时间均无交互效应(均P>0.05)。两组苏醒时间及丙泊酚用量比较,差异均无统计学意义(均P>0.05)。观察组术中呼吸抑制发生率低于对照组(P<0.05),而两组患者术中体动、嗜睡、恶心呕吐及术后镇静药物使用率比较,差异均无统计学意义(均P>0.05)。结论丙泊酚复合纳布啡用于无痛人流的静脉麻醉临床效果好,不良反应发生率低,安全性好。

Objective To observe the effect and safety of intravenous anesthesia with propofol and nalbuphine applied to painless abortion. Methods Sixty patients undergoing painless abortion were randomly divided into observation group and control group,with 30 cases in each group. The observation group received anesthesia with propofol and nalbuphine,while the control group were given anesthesia with propofol plus sufentanil. The mean arterial pressure（MAP）,heart rate,RR and arterial oxygen saturation（SpO2） were recorded in both groups before operation,at the beginning of operation,at the end of operation,at 5 and 10 minutes after operation. The awakening time,Visual Analogue Scale（VAS） scores at 5,15,30 and 60 minutes after awakening,consumption of propofol,and incidence of adverse reaction within 60 minutes after operation were also recorded in the two groups. Results No significant difference was found in the MAP,heart rate,RR,SpO2 level or VAS score between the two groups（all P〈0. 05）,MAP,heart rate,RR and VAS score all changed over time in the two groups（all P〈0. 05）,but the level of SpO2 did not change with time in the two groups（all P〉0. 05）,and no interaction was observed between group and time（all P〉0. 05）. There was no significant difference between the two groups in the awakening time or consumption of propofol（all P〉0. 05）. The incidence rate of respiratory depression in the observation group was lower than that in the control group（P〈0. 05）,however,there was no significant difference in the incidence rate of intraoperative body movement,lethargy,nausea and vomiting,or medication for postoperative sedation between the two groups（all P〉0. 05）. Conclusion Intravenous anesthesia using propofol combined with nalbuphine has favorable effects on painless abortion,with lower incidence rate of adverse reactions and excellent safety.