右美托咪定喷鼻联合丙泊酚在无痛人工流产术中的麻醉效果

Anesthetic Effect of Dexmedetomidine Nasal Spray Combined with Propofol in Painless Induced Abortion

目的:探讨右美托咪定(Dex)喷鼻联合丙泊酚在无痛人工流产术中的麻醉效果。方法:选取2017年2月-2019年1月收治的90例行无痛人工流产术患者,随机分成三组,各30例。术前30 min,P、DL、DH组经两侧鼻孔分别等量喷入0.9%氯化钠溶液及0.5、1.0μg/kg Dex各1 ml。观察并比较三组丙泊酚用药总量、麻醉诱导时间、手术时间、苏醒时间、不良反应发生率、麻醉效果、Ramsay镇静评分、患者满意度、手术者满意度、麻醉前后视觉模拟评分法(VAS)评分、焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分。结果:三组手术时间比较,差异无统计学意义(P>0.05)。DL组和DH组丙泊酚用药总量、苏醒时间及不良反应发生率均优于P组,DH组丙泊酚用药总量少于DL组(P<0.05)。DL组、DH组麻醉总有效率、Ramsay镇静评分、患者满意度、手术者满意度均优于P组(P<0.05)。三组麻醉前VAS、SAS和SDS评分比较,差异均无统计学意义(P>0.05)。DL组、DH组麻醉后VAS、SAS和SDS评分均低于P组,DH组VAS、SAS和SDS评分均低于DL组,差异均有统计学意义(P<0.05)。结论:右美托咪定喷鼻联合丙泊酚在无痛人工流产术中的麻醉效果确切,可有效缓解患者术后的疼痛程度,改善术后心理状态,缩短麻醉起效时间及术后完全苏醒时间,降低丙泊酚用量,提高患者及手术者满意度,降低术后不良反应发生率,可有效保证手术的顺利进行。

Objective: To investigate the anesthetic effect of Dexmedetomidine nasal spray combined with Propofol in painless induced abortion. Method: Ninety patients with painless induced abortion from February 2017 to January 2019 were randomly divided into three groups, with 30 cases in each group. Thirty minutes before operation, 0.9% Sodium Chloride Solution, 0.5 and 1.0 μg/kg Dexmedetomidine were injected through the nostrils of both sides in the P group, the DL group and the DH group. The total dosage of Propofol, induction time of anesthesia, operation time, recovery time, incidence of adverse effection, anesthesia effect, Ramsay sedation scores, patients’ satisfaction, operators’ satisfaction, visual analogue scale(VAS) scores, self-rating anxiety scale(SAS) and self-rating depression scale(SDS) scores before and after anesthesia were observed and compared among the three groups. Result: The operation time of the three groups was compared, and the difference was not statistically significant(P>0.05). The total dosage of Propofol, recovery time and incidence of adverse effection in the DL group and the DH group were better than those of the P group, and the total dosage of Propofol in the DH group was lower than that of the DL group(P<0.05). The total effective rate of anesthesia, Ramsay sedation scores, patients’ satisfaction, operators’ satisfaction of the DL group and the DH group were better than those of the P group(P<0.05). VAS, SAS and SDS scores before anesthesia were compared in three group, and the differences were not statistically significant(P>0.05). After anesthesia, VAS, SAS and SDS scores in the DL group and the DH group were lower than those of the P group, and VAS, SAS and SDS scores in the DH group were lower than those of the DL group, and the differences were statistically significant(P<0.05). Conclusion: The anaesthesia effect of Dexmedetomidine nasal spray combined with Propofol in painless induced abortion is exact. It can effectively alleviate the degree of pain after operation, improve the psychological state after operation, shorten the onset time of anesthesia and the time of complete recovery after operation, reduce the dosage of Propofol, improve the satisfaction of patients and operators, and reduce the incidence of adverse effection after operation. It can effectively ensure the operation.