米索前列醇应用于异丙酚无痛人流术中的效果观察

THE EFFECT OF APPLICATION OF MISOPROSTOL AND PROPOFOL IN PAINLESS INDUCED ABORTION

目的 :观察口服米索前列醇对小剂量异丙酚全麻无痛人工流产术中的作用。方法 :6 0例行无痛人流术患者随机分为两组。分别以术前 4h口服米索前列醇 4 0 0 μg(A组 )或术前不服药 (B组 )+异丙酚 2mg/kg诱导 ,注药速度控制在 2～ 3min完成 ,术中据挣动情况追加异丙酚 (追加量为首剂量 1/2 )。观察麻醉效果 ,宫颈松驰 ,用药量 ,手术时间 ,追加药例数及注药前、注药后 2分、术毕的血压、心率、呼吸的变化。结果 :A组麻醉效果佳 (优秀率为 86 .7% ) ,明显优于B组 (优秀率为4 0 .0 % ) ;A组、B组的宫颈松驰、用药量、手术时间、追加药例数比较有极显著性差异 (P <0 .0 1) ;A组注药前、注药后 2分、术毕的血压、心率、呼吸变化无显著性差异 (P >0 .0 5 ) ,B组术毕血压、心率与注药前比较有显著性差异 (0 .0 5 >P >0 .0 1) ,呼吸暂停 4例。结论 :米索前列醇应用于异丙酚无痛人流术可提高麻醉效果 ,减少异丙酚用药量 ,降低异丙酚对循环、呼吸的抑制作用。

Objective: To observe the effect of combined application of misoprostol and small dose propofol in painless induced abortion. Methods: Sixty patients receiving painless abortion were classified randomly into two groups. Group A: received misoprostol 400μg 4 hours before operation; Group B: without misoprostol. Both were given propofol 2mg/kg to induce general anesthesia. The speed of injection was kept within 2～3 minutes. Additional dosage of propofol were given according to the situation during operation (the dosage of supplementory propofol is a half of the prime dosage). The following parameters were observed: the anesthetic effect, the loosening of cervix, the dosage of the medicine, the operative time, the cases receiving supplementory medicine, blood pressure, heart rate and respiration before injection, two minutes after injection, and after operation. Results: the anesthetic effect of Group A (the excellence ratio is 86.7%)is superior to Group B (the excellence ratio is 40%). There is significant difference on the loose cervix, the required dosages of the medicine and the cases of supplementory medicine between Group A and Group B ( P >0.01). A significant difference in pre and post operation level blood pressure, heart rate and respiration was found in group B, but not in group A. Conclusion: the application of misoprostol to propofol for painless induced abortion enhanced the anesthetic effect, reduced the dosages of propofol and as well as the suppressive effect of propofol on circulation and respiration.