摘要
目的对芬太尼联合丙泊酚在无痛人流术的麻醉效果和安全性进行观察。方法选择2012年5月—2013年6月在海宁市妇幼保健院自愿要求行无痛人工流产术的112例孕妇,随机分为2组,每组56例,A组应用丙泊酚麻醉,B组应用芬太尼联合丙泊酚进行麻醉。观察并记录2组孕妇在麻醉诱导前、麻醉诱导后、手术5 min中及手术完成这些时间点的平均动脉压(MAP)、心率(HR)和脉搏血氧饱和度(Sp O2);记录所有孕妇的术中疼痛反应、丙泊酚用量、起效时间、清醒时间及术中、术后不良反应。结果 2组患者在麻醉诱导前MAP、HR、Sp O2的比较差异均无统计学意义(t值分别为1.374,1.267,1.047,P>0.05);与诱导前比较,2组在麻醉诱导后的MAP、HR、Sp O2均下降,且组间比较差异无统计学意义(P>0.05);但手术开始5 min后A组的MAP、HR较B组明显升高(t值分别为2.413,2.558,P均<0.05);而B组在各个时间点的MAP、HR、Sp O2变化差异均无统计学意义(P>0.05);虽然2组患者的麻醉起效时间差异无统计学意义(P>0.05),但术后清醒时间及术中丙泊酚总用量B组均显著小于A组(P<0.05);A组患者术中出现呼吸抑制、循环抑制、体动及术中疼痛均显著性高于B组(P<0.05);术后常见的并发症如恶心呕吐等的发生率无明显差异。结论丙泊酚联合芬太尼用于无痛人流,麻醉效果好,可减少丙泊酚用量,苏醒时间短,术中不良反应少,术后疼痛轻,值得临床推广。
Objective To observe the effects and safety of combined intravenous anesthesia with fentanyl and propofol during painless induced abortion surgery. Methods From May 2012 to June 2013 in our hospital 112 pregnant women undergoing the painless induced abortion surgery were randomly divided into two groups （56 cases in each group） ;The Group A received propofol for anesthesia and the Group B received propofol combined with sufentanil for anesthesia. Mean arterial pressure （MAP）, heart rate （HR） and pulse oxygen saturation （SpO2 ） of both groups were observed and recorded at the time of before induction, after induction, intraoperative and after operation ; Intraoperative pain reactions, the dosages of propofol,working time, awake time and intraoperative and postoperative adverse reactions of all the pregnant women were recorded. Results MAP, HR and SpO2 of the two groups had no statistically significant difference before the anes- thesia induction（ t were 1. 374,1. 267 and 1. 047, P 〉 0.05 ） ;MAP, HR and SpO2 decreased not clearly in both groups after the anesthesia induction and the difference was not statistical significance（ P 〉 0. 05 ） ;But 5 min after abortion surgery,both MAP and HR in group A increased significantly as compared with those in the group B（t were 2. 413,2. 558 ,P 〈 0.05 ）, while there was no obvious changes in MAP, HR and SpO2 at each time points in the group B （ P 〉 0.05 ） ; There was no significant difference between the two groups in terms of anesthesia working time（ P 〉 0. 05 ）, but the waking hours and total dosages of propofol in the Group B were significantly less than that in the Group A （ P 〈 0.05 ） ; The incidence rates of breathing inhibition, circulation inhibition, dynamic and intraoperative pain in Group A were significantly higher than that of Group B （P 〈 0.05 ） ;there was no significant differences in the incidences of postoperative nausea, dizziness and vomiting between the two groups （P 〉 0.05）. Conclusion The eff
出处
《中华全科医学》
2015年第1期45-47,160,共4页
Chinese Journal of General Practice
关键词
丙泊酚
芬太尼
无痛人流
临床观察
Propofol
Fentanil
Painless induced abortion
Clinical observation
