右美托咪定复合丙泊酚和芬太尼在无痛人流术中的应用观察

Application of Dexmetomidine Combined with Propofol and Fentanyl in Painless Induced Abortion

目的观察右美托咪定复合丙泊酚和芬太尼在无痛人流术中的应用。方法选择择期行无痛人流术的患者400例,随机分为丙泊酚和芬太尼组(P组)以及右美托咪定复合丙泊酚和芬太尼组(EP组)。术前2 min给予芬太尼0.5μg/kg静注,术中丙泊酚以靶控(TCI)模式输注,右美托咪定以恒速模式输注,根据患者镇静深度适当调整注射速度。记录所有患者的药物起效时间、操作时间、苏醒时间以及出室时间,并记录低血压、心动过缓、缺氧和注射痛等不良事件。结果 EP组围术期低血压、心动过缓、缺氧、注射痛发生率较P组显著降低,差异具有统计学意义(P<0.01);EP组患者的起效时间较P组长,差异有统计学意义(P<0.05),而两组患者操作时间、苏醒时间、出室时间以及出室前VAS值差异无统计学意义(P>0.05)。结论右美托咪定复合丙泊酚和芬太尼在无痛人流术中对呼吸、循环系统影响小,注射痛发生率更小,显著提高无痛人工流产术的安全性及舒适性。

Objective To observe the application of dexmetomidine combined with propofol and fentanyl in painless abortion.Methods 400 patients undergoing painless abortion were randomly divided into propofol and fentanyl group(P group)and Dexmedetomidine combined with propofol and fentanyl group(group EP).Preoperative 0.5μg/kgfentanyl intravenous injection2 min before the operation,intraoperative infusionof propofol in target controlled(TCI)mode,dexmedetomidine infusion at a constant speed mode,adjust the injection speed according to the depth of sedation of patients.Drug onset time,operation time,recovery time and ventricular exit time were recorded in all patients.Adverse events such as hypotension,bradycardia,anoxia and injection pain were recorded.Results The incidence of hypotension bradycardia hypoxia and injection pain in EP group was significantly lower than that in P group,the difference was statistically significant(P<0.01).The onset time of EP group was significantly higher than that of P group,the difference was statistically significant(P<0.05).However,there was no significant difference in operation time,recovery time,ventricular exit time and VAS value between the two groups(P>0.05).Conclusion Dexmetomidine combined with propofol and fentanyl has little effect on respiratory and circulatory system and less incidence of injection pain during painless artificial abortion,which can significantly improve the safety and comfort of painless induced abortion.