摘要
目的 探讨帕瑞昔布钠超前镇痛对丙泊酚复合芬太尼行无痛人工流产病人麻醉效果的影响。方法自愿接受无痛人工流产术的妇女160例,均为初次妊娠,随机双盲法分为两组,每组各80例,试验组病人采用帕瑞昔布钠40mg静脉注射,15min后静脉注射芬太尼1μg/kg,之后静脉注射丙泊酚1.5mg/(kg·min),意识消失后手术;对照组以等量的生理盐水代替帕瑞昔布钠,其余同试验组。对术中麻醉效果差的病人,每次静脉注射丙泊酚0.5mg/kg。观察两组病人入手术室后术前平均动脉压(MAP)、心率(HR)以及血氧饱和度(SpO2)基础值,术中MAP、HR及SpO2最低值;记录两组病人术中呼吸抑制发生率;术后30min恶心呕吐、头晕嗜睡、梦境幻觉等副作用的发生率及腹痛发生率、视觉模拟评分法(VAS)评分;记录两组麻醉优良率、丙泊酚用量、手术时间、清醒时间及VAS评分。结果 与对照组比较,试验组术中麻醉优良率及SpO2最低值显著升高,丙泊酚用量、呼吸抑制发生率、术后腹痛发生率及VAS评分显著降低(t=2.899~3.982,χ^2=5.378~42.133,P<0.05);两组术中MAP和HR最低值、手术时间、清醒时间及术后恶心呕吐、头晕嗜睡、梦境幻觉副作用发生情况差异无统计学意义(P>0.05)。结论帕瑞昔布钠超前镇痛辅助丙泊酚与芬太尼麻醉进行无痛人工流产术可减少丙泊酚用量及呼吸抑制发生率,改善麻醉效果,而不增加其副作用。
Objective To investigate the effect of parecoxib sodium preemptive analgesia on the anesthetic effect of propofol combined with fentanyl in patients undergoing painless induced abortion.Methods A double-blind randomized trial was performed for 160 women with pregnancy for the first time who were willing to accept painless induced abortion.These women were randomly divided into experimental group and control group,with 80 patients in each group.The women in the experimental group were given intravenous injection of parecoxib sodium 40 mg,followed by fentanyl 1μg/kg 15 min later and then propofol 1.5 mg/(kg·min),and those in the control group were given an equal volume of normal saline instead of parecoxib sodium,followed by the same treatment in the experimental group.Intravenous injection of propofol 0.5 mg/kg was given for the patients with poor anesthetic effect.The two groups were observed in terms of mean arterial pressure(MAP),heart rate(HR),and pulse oxygen saturation(SpO 2)before surgery in the operating room and the lowest values of MAP,HR,and SpO 2 during surgery;the incidence rate of intraoperative respiratory depression was recorded;the incidence rates of side effects(including nausea and vomiting,[JP2]dizziness and somnolence,and hallucination)[JP]and abdominal pain were recorded at 30 min after surgery,as well as Visual Ana-logue Scale(VAS)score;excellent and good rate of anesthesia,amount of propofol used,time of operation,time to awakening,and VAS score were also recorded for both groups.Results Compared with the control group,the experimental group had significantly higher excellent and good rate of anesthesia and lowest SpO 2 value and significantly lower amount of propofol used,incidence rates of respiratory depression and postoperative abdominal pain,and VAS score(t=2.899-3.982,χ^2=5.378-42.133,P<0.05).There were no significant differences between the two groups in the lowest values of MAP and HR during surgery,time of operation,time to awakening,and postoperative side effects including naus
作者
董华
杨晓红
李明娟
李晓征
王君涛
褚海辰
DONG Hua;YANG Xiaohong;LI Mingjuan;LI Xiaozheng;WANG Juntao;CHU Haichen(Department of Anesthesiology,The Affliated Hospital of Qingdao University,Qingdao 266003,China)
出处
《精准医学杂志》
2019年第6期506-508,共3页
Journal of Precision Medicine
关键词
帕瑞昔布钠
二异丙酚
芬太尼
镇痛
流产
人工
麻醉药
联用
麻醉效果
Parecoxib sodium
Propofol
Fentanyl
Analgesia
Abortion
induced
Anesthetics
combined
Anesthetic effect
