异丙酚联合氧化亚氮吸入麻醉用于人工流产术的临床观察

Clinical study on combined disoprofol and nitrous oxide anesthesia in induced abortion

目的 评价异丙酚联合氧化亚氮 (笑气 )吸入麻醉用于人工流产术的疗效和安全性。方法 2 4 0例自愿要求终止妊娠的健康孕妇 ,随机分为四组 ,各 6 0例。P F组 :芬太尼 1μg/kg与异丙酚 2mg/kg静注 ,术中根据效果追加异丙酚 ;N2 O组 :手术前 2min吸入 5 0 %N2 O O2 混合气 ,手术结束前 1min停吸 ;P N组 :同N2 O组法吸入混合气 ,同时静注 1 0mg/kg异丙酚 ,术中酌情追加 ;对照组 (B组 )未用麻醉。 结果 P N组呼吸循环稳定 ,与P F组差异有显著意义 (P <0 0 5 )。P F组、P N组无痛率 10 0 % ,明显高于对照组 (2 6 7% )和N2 O组 (78 3% ) (P <0 0 1)。初醒时间 :N2 O组 2 71± 1 12min和P N组 3 11± 1 17min短于P F组5 6 4± 1 35min(P <0 0 5 )。P N组无人流综合征 (PASS)发生 ,明显低于对照组 (13例 ) ,P N组无呼吸暂停 ,明显低于P F组 (9例 ) (P <0 0 1)。结论 异丙酚联合笑气吸入麻醉行人工流产术安全高效 ,呼吸循环稳定、清醒快、并发症少。

Objective To observe the effect and safety of combined disoprofol and nitrous oxide anesthesia in induced abortion.Methods A total of 240 early pregnant women were randomly divded into 4 groups,each group consisted of 60 cases.Group P-F:fentanyl 1μg/kg and disoprofol 2mg/kg infusion,supplemental disoprofol based on the effect of anesthesia during operation.Group N 2O:inhaled mixed 50% nitrous oxide-50% oxygen began at 2min before operation till 1min before operation stopped.Group P-N:inhaled 50% nitrous oxide-50% oxygen as in group N 2O,and disoprofol 1mg/kg infusion,supplemental disoprofol based on the effect of anesthesia during operation.Group B:without anesthsia.The indicators of respiration and circulation were measured.Results The BP,HR,R,SpO 2 in group P-F were much lower than those before medication,and were stable in the other groups.The difference between group P-N and group P-F was significant(P<0.05).The analgesic effects in group P-F(100%) and group P-N(100%) were much better than that in group N 2O(78.3%) and group B(26.7%).The analgesic effect in group N 2O were much better than that in group B(P<0.01).The reviving time in group N 2O was 2.71±1.12min and in group P-N was 3.11±1.17min which were shorter than that in group P-F(5.64±1.35 min)(P<0.05).The incidence of PASS in group B(13 cases) was much more than that in other groups(P<0.01).The apnea in group P-F was found in 9 cases while in group P-N didn't occur(P<0.01).Conclusion The combined disoprofol and nitrous oxide anesthesia for induced abortion safely achieved obvious analgesic effect with stable respiration and circulation condition,rapid revivescence and few complications.