右美托眯啶复合异丙酚-芬太尼麻醉用于人工流产术中的麻醉效果

目的探论右美托咪啶复合异丙酚-芬太尼在人工流产术中的麻醉效果。方法择期行人工流产术的女性患者60例，年龄20—40岁，ASA分级I或Ⅱ级，采用随机数字法将其分为两组：异丙酚-芬太尼组（PF组）30例和右关托咪啶复合异丙酚-芬太尼组（DPF组）30例。在DPF组，麻醉诱导前15min于10min内静脉输注右美托咪啶负荷剂量0．5μg/kg。在DPF组和PF组，麻醉诱导：分别在30S内经静脉推注异丙酚1．O～1．5mg／kg，芬太尼1．0～1．5μg／kg，然后异丙酚2～5mg／（kg·h）维持。记录术中异丙酚和芬太尼的用量、麻醉诱导时间、手术时间、清醒时间和术中不良反应的发生情况。结果与PF组比较，DPF组术中异丙酚和芬太尼的使用剂量、麻黄素使用率、低血压及呼吸抑制的发生率、记忆程度评分均降低（P〈0．05），术后清醒时间缩短（P〈0．05），心动过缓发生率和阿托品使用率比较差异无统计学意义（P〉0．05）。结论与异丙酚一芬太尼比较，右美托咪啶复合异丙酚一芬太尼可为人工流产术提供更好的麻醉效果，患者的安全及舒适度增高。

Efficacy of anesthesia with dexmedetomidine combined with propofol and fentanyl on patients undergoing artificial abortion

Objective To investigate the efficacy of anesthesia with dexmedetomidine combined with propofol and fentanyl on patients undergoing artificial abortion. Methods Sixty ASA I or 1I female patients, aged 20 - 40 years, undergoing artificial a- bortion, were randomly divided into two groups ：dexmedetomidine combined with propofol-fentanyl group （group DPF, 30 cases） and propofol-fentanyl group（ group PF, 30 cases）. In group DPF, a loading dose of dexmedetomidine 0. 5 Ixg,/kg was infused o- ver 10 min at 15 min before anesthesia induction. In group DPF and group PF, anesthesia was induced with intravenous infusion of propofol 1.0 - 1.5 mg/kg for 30 s, then induced with intravenous infusion of fentanyl 1.0 - 1.5 p,g/kg for 30 s. Anesthesia was maintained with intravenous infusion of propofol 2 - 5 mg/（ kg ~ h）. The amount of propofol and fentanyl, anesthesia induc- tion time, opration time, eye-opening time, complications during operation were recorded. Results The amount of propofol and fentanyl, the incidence of respiratory depression and hypotension, the utilization of ephedrine and the memory score of anesthesia and operation, were lower in group DPF than those in group PF（ P 〈 0. 05 ）. Postoperative eye-opening time was shorter in group DPF than that in group PF（ P 〈 0. 05 ）. There was no significant difference in the incidence of bradycardia and the utilization of atropine between the two groups （P 〉 0.05）. Conclusion Dexmedetomidine combined with propofol and fentanyl can provide more satisfactory efficacy on artificial abortion than propofol-fentanyl. The patients＇ degrees of safety and comfort are improved.