236例无痛人工流产术的疗效观察

目的:探讨异丙酚和芬太尼混合液静脉麻醉、笑气吸入麻醉及2%利多卡因宫颈局部浸润麻醉三种镇痛方法在人工流产手术中的疗效比较。方法:自2003年8月至2004年1月对236例妇科门诊早孕要求终止妊娠的妇女实施无痛人工流产术。随机分成3组。A组:异丙酚+芬太尼静脉麻醉(85例);B组:N2O(笑气)吸入麻醉(88例);C组:2%利多卡因宫颈局部浸润麻醉(63例),观察人流术中其镇痛效果并对疼痛进行分级。结果:A组85例100%可达到完全不痛(疼痛分级为0级);B组65.90%可达到完全不痛,Ⅰ级23.86%,Ⅱ级9.09%,Ⅲ级1.15%;C组0例可达到完全不痛,Ⅰ级63.49%,Ⅱ级30.16%,Ⅲ级6.35%。结论:受术者如无心肺疾患及人流禁忌证,无痛人工流产术应选择异丙酚+芬太尼静脉麻醉可达到完全无痛,痛苦最小。

Curative effect study on the 236 cases with nopainful artificial abortion operation

Objective Studying the curative effect comparison of the three anaesthesial methods to relieve pain in the artificial abortion operation between injecting the mixed liquid of Propofol and Fentanyl to anaesthesize,inhaling Laughing Gas to anaesthesize and local anaesthesizing by infiltrating cervix with 2% Lidocaine. Method From August 2003 to January 2004, 236 cases gynecology out-patient service early pregnant requesting terminating gestation received nopainful artificial abortion operation. They were allocated into 3 groups randomly. A set:anaesthetized by injecting the mixed liquid of Propofol and Fentanyl(85 cases); B set: anaesthetized by inhaling Laughing Gas(88 cases); C set: local anaesthesized by infiltrating cervix with 2% Lidocaine(63 cases). Observing the effect of relieving pain and proceeding ache rating during the artificial abortion operation. Results All 85 cases of A set can attain completely nopain(ache rating is 0 class). In B set,65.09% of them can attain completely nopain, I class consists 23.86%, Ⅱ class consists 9.09%, Ⅲ class consists 1.15%. In C set, 0 case can attain completely nopain, I class consists 63.49%, Ⅱ class consists 30.16%, Ⅲ class consists 6.35%. Conclusion If the patient has no heart and lung disease, without taboo of artificial abortion operation. He should choose being injected the mixed liquid of Propofol and Fentanyl to anaesthesize and he would attain completely nopain and bear least pain.