脑电双频指数监测下地佐辛与舒芬太尼复合丙泊酚在无痛人工流产术中的应用比较

Comparison of clinical application of intravenous dezocine or sufentanil combined with propofol under bispectral index monitoring in painless artificial abortion

目的脑电双频指数(bispectral index,BIS)监测下观察地佐辛和舒芬太尼复合丙泊酚在门诊无痛人工流产术中的有效性及安全性。方法选取2016年3月至5月择期行人工流产术患者48例,随机分为D、S两组(n均为24)。两组患者均在BIS监测下,D组给予地佐辛0.05mg/kg复合丙泊酚麻醉;S组给予舒芬太尼0.10μg/kg复合丙泊酚麻醉。记录两组患者麻醉诱导前(T0)、诱导结束时(T1)、扩宫颈时(T2)、吸宫结束时(T3)、苏醒后即刻(T4)、苏醒后20分钟(T5)的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、指脉血氧饱和度(pulse oxygen saturation,Sp O2)、BIS值;记录手术时间、苏醒时间、定向力恢复时间、丙泊酚用量、麻醉效果、麻醉期间不良反应(注射部位痛、体动、呼吸抑制、术后恶心、呕吐、头晕等)的发生率,以及患者苏醒后即刻和苏醒后20分钟下腹疼痛的VAS评分。结果两组患者在各时间点的MAP、HR、Sp O2、BIS值组间比较差异无统计学意义(P>0.05);两组患者丙泊酚用量、清醒时间、定向力恢复时间、麻醉效果、术中术后不良反应发生率、苏醒后即刻下腹疼痛VAS评分比较,差异无统计学意义(P>0.05)。两组患者苏醒后20分钟下腹疼痛VAS评分比较,差异有统计学意义(P<0.05)。结论地佐辛0.05mg/kg与舒芬太尼0.10μg/kg复合丙泊酚麻醉均可安全有效地用于无痛人工流产术中,且地佐辛术后镇痛时程要优于舒芬太尼。

Objective To study the efficacy and safety of intravenous anesthesia usingdezocine or sufentanil combined with propofol under bispectral index(BIS) monitoring inpainless artificial abortion. Methods A total of 48 patients underwent painless artificialabortion from March 2016 to May 2016 were randomly divided into 2 groups(Each group of24 cases),Group D(dezocine 0.05mg/kg combined with propofol under BIS monitoring)andGroup S(sufentanil 0.10μg/kg combined with propofol under BIS monitoring).The mean arterialpressure(MAP), heart rate(HR),pulse oxygen saturation(SpO2) and BIS value were recorded atthe time points of pre-anesthesia(T0),post-anesthesia(T1),cervical dilatation(T2), the end of theoperation(T3),awakening(T4) and 20 minutes after awakening(T5).The operation duration,thetime of recovery and orientation recovery,the total dosage of propofol,anesthesia effect, adversereaction rate(injection pain,involuntary movement,respiratory depression,postoperative nausea,emesis,dizziness)and postoperative visual analogue scale(VAS) at T4 and T5 were recorded.Results There were no significant differences in MAP,HR,SpO2 and BIS value at the six timepoints between the two groups(P ?? 0.05).There were no significant differences between the two groups in operation duration, recovery time,orientation recovery time,the total dosage ofpropofol,anesthesia effect, adverse reaction rate and VAS(Visual Analogue Scale) pain at T4(P??0.05). Compared with group S,VAS pain at T5 in group D decreased significantly(P??0.05).Conclusion Intravenous anesthesia using dezocine at 0.05mg/kg or sufentanil at 0.10μg/kgcombined with propofol is safe and effective in painless artificial abortion, and the analgesiaeffect of dezocine is better than that of sufentanil.