小剂量芬太尼、异丙酚全麻用于人工流产术的临床观察

Clinical observation of intravenous anesthesia with small doses of fentanyl plus propofol for termination of pregnancy

目的 探讨小剂量芬太尼、异丙酚联合全麻用于人工流产术可行性和安全性。方法 64例ASAⅠⅡ级早孕妇女 ,静注芬太尼≤ 1 μg/kg ,于扩张宫颈前 ,缓慢静注异丙酚 ,诱导首次量 1mg/kg ,根据孕妇耐受扩宫、吸宫、清宫酌情追加麻药 ,记录收缩压、舒张压、心率、SpO2 变化、睫毛反射消失及恢复时间、用药量和不良反应。结果 静注异丙酚后血压上升 2例 ,下降 62例 ,其中 1例因服降压药 ,血压明显下降 ,需用升压药维持至手术后 6h。心率 <60次 /min7例 ,SpO2 下降至 94%以下 2 2例 ,下颌松驰 7例 ,有 2 2例睫毛反射迟顿 ,意识朦胧 ,对答切题 ,无痛觉。术毕 7min清醒 ,休息 2 0 30min离院。结论 小剂量芬太尼加异丙酚用于人工流产术的麻醉 ,可达到完善的镇静、镇痛作用 ,苏醒迅速。因总用药量小 ,推注速度慢 ,血压下降幅度与呼吸抑制大多较轻 ,但个体差异特别显著。

Objective To investigate the possibility and security with small doses of fentanyl and propofol anesthesia for early pregnancy termin ation. Methods A total of 64 ASAⅠ~Ⅱearly pregnancy women were sched uled for this study. Before dilatating uterine cervit,fentanyl 1 μg/kg was inje cted per intravenous line followed by propofol 1mg/kg through iv slowly for indu ction. Then, according to the pregnancy women conditions to tolerate the operati on the anesthetics were added to maintain satisfactory anesthesia. During the op eration, the SBP, DBP, HR, SpO 2, times of vanishing and recovering, eyelash ja rk, doses and adverse reactions were recorded. Results During propofo l induction and operation, 42 case had loss ofconsciousnes s,but the other 2 2cases remained conscious with out complaints about pain .Intra pos to perative terms,nonausea and vomitting were observed .Other finding sincluded:BP declinein 62case ,lessthan 60 beat/minin 7cases,SpO2 lessthan 94%in 2 2cases,jawre laxin 7cases.After completion of operationallpa tient sgained consciousness(except for a few cases)fastranging from immediately to 7minas sessed by opening eyes,spontaneous wearete.Thetimeforhomereadinesswere 2 0 3 0min .Conclusion In travenousanes the sia with small doses of fentanyl and propofol for early termina tion pregnancyisa simple,safe and effective ane sthet icmethod.