无痛人流麻醉方法的优化选择

Optimal selection of anaesthesia method in painless abortion

目的:研究咪唑安定、丙泊酚复合瑞芬太尼用于人流手术的麻醉效果和安全性。方法:收治首次人流手术患者90例,随机分为3组,每组30例。A组给予丙泊酚,B组给予丙泊酚联合芬太尼,C组给予力月西、丙泊酚、瑞芬太尼,比较3组麻醉效果和不良反应。结果:和术前比,A组睫毛反射消失时、扩宫时的MAP、HR显著降低,吸宫时MAP、HR显著增高(P<0.05)。B组睫毛反射消失时、扩宫时、吸宫时MAP、HR显著降低(P<0.05)。麻醉效果分级:A组优2例,良18例,差10例。B组优18例,良12例,差0。C组优25例,良5例,差0。A、B组诱导、唤醒及定向力恢复时间明显延长,C组诱导时间短、术后苏醒快、定向力恢复快。结论:咪唑安定、丙泊酚复合瑞芬太尼用于人流手术较丙泊酚麻醉、丙泊酚复合芬太尼麻醉更为安全、有效。

Objective:To explore the anesthesia effect and safety of midazolam combined propofol and fentanyl in painless abortion.Methods:90 cases of patients with first abortion were randomly divided into three groups,with 30 cases in each group.Group A were given propofol;group B were given propofol combined fentanyl;group C were given rhythim combined propofol and fentanyl.The anesthesia effect and adverse reaction of the three groups were compared.Results:Compared with pre-operation,the MAP and HR of group A as eyelash reflex disappearing and enlarging womb were reduced significantly,and the MAP and HR as uterine aspiration were improved significantly(P<0.05).The MAP and HR of group B as eyelash reflex disappearing,enlarging womb and uterine aspiration were reduced significantly(P<0.05).Anesthesia effect classification:group A had 2 cases of optimal effect,18 cases of good effect,10 cases of poor effect.Group B had 18 cases of optimal effect,12 cases of good effect,0 cases of poor effect.Group C had 25 cases of optimal effect,5 cases of good effect,0 cases of poor effect.The induction,awaken and orientation recovery time of group A and group B prolonged obviously,and group C had short induction time,awakened quickly and the orientation recovered quickly.Conclusion:Midazolam combined propofol and fentanyl used in painless abortion was more safe and effective than that of propofol anesthesia,propofol combined fentanyl.