异丙酚复合芬太尼静脉麻醉镇痛对门诊人工流产术的影响

Use of analgesia consists of propofol and fentanyl in outpatient artificial abortion

目的:观察异丙酚复合芬太尼静脉麻醉对于人工流产术时及术后的影响。方法:选择2001年3月——2001年9月在本院计划生育门诊就诊、自愿要求无痛人工流产的妇女120例作为无痛人工流产组(简称:无痛组),同期按常规方法行人工流产的妇女120例作为对照组(简称:对照组),进行配对研究。无痛组用异丙酚1.5mg/kg复合芬太尼2μg/kg诱导,术中用异丙酚维持,人工流产术按常规方法施行。结果:无痛组术中异丙酚用量为2.7±0.7mg/kg,芬太尼2μg/kg,术中无知觉,120例妇女均无疼痛主诉。对照组轻度疼痛82例(68.3％),中度疼痛33例(27.5％),重度疼痛3例(4.2％)。无痛组在麻醉诱导及维持期间均出现呼吸频率下降,通过控制呼吸、面罩吸氧,SaO_2可以保持在99％以上,不需气管插管。两组妇女术前及术后宫腔深度无明显差异(P>0.05)。无痛组术中出血量为32.2±23.2ml,对照组为19.8±15.9ml,无痛组较对照组明显增多,有极显著统计学差异(P<0.01)。结论:异丙酚复合芬太尼静脉麻醉对人工流产术的主要影响是手术的出血量略增多,但不影响子宫收缩及术后恶露持续时间,该麻醉是一种有效镇痛方法,适用于门诊人工流产术。

Purpose:To evaluate the effectiveness of propofol combined with fentanyl in outpatients undergoing artificial abortion. Methods: Form March 2001 through September 2001, 120 volunteers constituted the study group,received intravenous sedation consist of propofol 1. 5 mg/kg and fentanyl 2ug/ kg infusion,and intravenous 30 -50mg/kg propofol if necessary,other 120 outpatients as control group. All groups had similar operative procedures. We observed the effect of analgesia, measured the blood loss during operation and the depth of the uterine cavity before and after the operation. Datum were collected and analyzed using test. Result: The patients in the study group used propofol 2.70 mg/kg have good analgesic effect, butmore blood loss during the operation than that in the control group with significant difference(P>0.01). Conclusion;It was an effective method using propolfol combined with fentanyl in the outpatient artificial abortion. Althouh more blood loss during the operation,but it was a safe procedure.