曲马朵及芬太尼与丙泊酚联合用于人工流产麻醉的临床比较

Comparison of the Effect of Propofol Combined with Fentanyl or Tramadol for Induced Abortion

目的 :观察芬太尼及曲马朵联合应用于无痛人流的效果。方法 :将无痛人流病人 75例随机分成 3组 (每组 2 5例 )。Ⅰ组 :静脉注入 0 .5 μg/kg芬太尼后 ,立即以 3.0kg-1·min-1注入丙泊酚 ,1min后开始手术。Ⅱ、Ⅲ组病人分别预注曲马朵2 .0mg/kg、2 .5mg/kg后再静脉注入相同剂量的丙泊酚。 结果 :3组病人手术开始时血压 (BP)、心率 (HR)和脉搏氧饱和度(SpO2 )及呼吸频率分别较麻醉前下降了 2 1%、18%、84 % ,(P <0 .0 1) ,呼吸频率抑制的持续时间平均为 5 2s ,意识恢复时间平均为 9.4 5min ,与Ⅱ、Ⅲ组比较差异显著 (P <0 .0 1)。结论 :丙泊酚与 2 .0mg/kg的曲马朵联合应用于人工流产 ,可明显减少术中病人的肢动反应。具有循环稳定和呼吸中枢抑制轻的优点 ,并在缓解术后宫缩痛方面有独特的功效。

Objective: To investigate the effect of propofol combined with fentanyl or tramadol for induced abortion. Methods: Seventy five patients undergoing induced abortion were randomly divided into three equal groups of each included twenty five patients. Group one: after injecting fentanyl 0.5 μg/kg, propofol 3.0 mg/kg was given,while in group two and three,instead of fentanyl,tramadol 2.0 mg/kg or 2.5 mg/kg was giveng respectively.Patients BP, HR, SpO 2,respiratory rate were monitored as well as the time of recovery and the rate of limb movement. Results: After induction of anesthesia in group one the blood pressure and heart rate was significant decreased and the incidence of respiratory depression was higher than that in the group two and three.The rate of limb movement was similary. Conclusion: propofol combined with tramadol 2.0 mg/kg is more stable in hemodynamics and more comfortable.