摘要
目的探讨丙泊酚联合曲马多、瑞芬太尼或氯胺酮在无痛人工流产术中的镇痛效果及其安全性。方法选取2014年3月至2015年3月于本院行无痛人工流产术的健康早孕女性90例作为研究对象，随机分为A组（丙泊酚联合曲马多）、B组（丙泊酚联合瑞芬太尼）、C组（丙泊酚联合氯胺酮）三组，每组各30例。麻醉后接受无痛人工流产术，比较三组研究对象镇痛效果、苏醒时间、离院时间以及麻醉前（T0）、麻醉后（T1）、术中（T2）和手术结束时（T3）平均动脉压（MAP）、心率（HR）和血氧饱和度（SpO2）的变化情况，统计三组研究对象术中不良反应发生情况。结果三组研究对象丙泊酚用量比较差异无显著性（P＞0.05）；术后30分钟A组视觉模拟评分法（VAS）评分低于B、C组（P＜0.05），B、C组VAS评分比较差异无显著性（P＞0.05）。A、B组苏醒时间和离院时间均短于C组（P＜0.05），但A、B组比较差异无显著性（P＞0.05）。B组T1-T3时MAP、HR和SpO2水平与T0比较差异具有显著性（P＜0.05），A、C组T1-T3时MAP、HR和SpO2水平与T0时比较差异无显著性（P＞0.05），A、C组间比较差异亦无显著性（P＞0.05）。A组术中发生呼吸抑制1例，肢动1例；B组发生呼吸抑制2例，肢动4例；C组发生呼吸抑制5例，肢动11例。C组不良反应发生率明显高于A、B组，差异均有显著性（P＜0.05）。结论丙泊酚联合曲马多在无痛人工流产术中镇痛效果良好，安全性较高，具有临床推广应用价值。
Objective To investigate the analgesic effect and safety of propofol combined with three different analgesic drugs in painless artificial abortion. Method Selected from March 2014 to March 2015 lines of painless artificial abortion operation in our hospital 90 cases of healthy pregnancy women, were randomly divided into group A （propofol combined tramadol） and group B （propofol combined fentanyl）, group C （propofol combined ketamine）, 30 cases in each group. After anesthesia, all of them received painless artiifcial abortion, compared three groups of patients with analgesia effect and awakening time, time of departure from the hospital, and anesthesia （T0） before and after anesthesia （T1）, intraoperative （T2）, and at the end of surgery （T3）, mean arterial pressure （MAP）, heart rate （HR） and the change of blood oxygen saturation （SpO2）. The occurrence of adverse reactions the three groups were counted. Result Three groups of propofol dosage had no signiifcant difference （P〉0.05）;after 30 minutes, the VAS scores in group A were lower than group B and C （P〈0.05）, group B and C VAS scores there was no signiifcant difference （P〉0.05）. Group A and group B of awakening time and time of departure from the hospital were shorter than group C （P〈0.05）, but group A and group B had no signiifcant difference （P 〉 0.05）. Dosage of propofol compared three groups of patients had no signiifcant difference （P〉0.05）;group B T1-T3 when MAP, HR, SpO2 levels had signiifcant difference compared with T0 （P〈0.05）, group A and group C T1-T3 when MAP, HR, SpO2 levels there were no signiifcant difference compared with T0 （P〉0.05）, and the differences between group A and C had no signiifcant （P〉0.05）;1 caseof respiratory depression in group A, 1 case of limb movement;group B respiratory depression occurred in 2 cases, limb movement 4 cases;respiratory depression in 5 cases, group C limb movement in 11 cases. Incidence of adverse reactions in group C
出处
《中国医学前沿杂志（电子版）》
2015年第4期58-61,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
