不同剂量瑞芬太尼、芬太尼在无痛人工流产术中对丙泊酚麻醉效果的影响

目的观察不同剂量瑞芬太尼、芬太尼在无痛人工流产术中对丙泊酚麻醉效果的影响。方法300例无痛流产患者随机分为5组，每组60例；即丙泊酚组（P组）、丙泊酚＋芬太尼1μg／kg组（F1组）、丙泊酚＋芬太尼2μg/kg组（F2组）；丙泊酚＋瑞芬太尼1μg／kg组（R1组）、丙泊酚＋瑞芬太尼2μg／kg组（R2组），P组直接缓慢静注丙泊酚，其他组首先缓慢静推瑞芬太尼或芬太尼1min后缓慢静注丙泊酚。结果丙泊酚用量P组为（2．5±0．4）mg／kg；F1组、R1组为（1．3±0．6）mg／kg，F2组、R2组为（1．0±0．6）mg／ks。恶心、呕吐发生率和呼吸抑制发生率F2组、R2组明显增加（P〈0．01）。术后宫缩痛P组较多（P〈0．01），R1组、R2组明显增多（P〈0．01）。苏醒时间R1组、R2组明显缩短（P〈0．01）。结论芬太尼、瑞芬太尼可以加强丙泊酚在人工流产中的麻醉作用，减少丙泊酚用量，但剂量过大明显增加呼吸抑制和恶心呕吐的发生率；芬太尼对术后宫缩痛的抑制效果好于瑞芬太尼，瑞芬太尼术后苏醒快。

The Effect of Remifentanyl or Fentanyl on Propofol Anesthesia for Induced Abortion

Objective To observe the effects of different dosage of remifentanyl or fentanyl on propofol anesthsia for indued abortion. Methods 300 induced abortion patients were randomly divided into five groups （n=60）：propofol group （group P）, propofol and 1 μg/kg fentanyl group（group F1）, propofol and 2μg/kg fentanyl group（group F2）, propofol and 1 μ g/kg remifentanyl group（group R1）, propofol and 2 μ g/kg remifentanyl group（group R2）, Group P was administrated propofol only,other groups were administrated different dosage remifentanyl or fentanyl first,and then use propofol 1 minute later. Results The dosages of propofol were （2.5 ± 0.4）mg/kg in group P; （1.0 ± 0.6）mg/kg in group group F1 and group R1; （1.0 ± 0.6）mg/kg in group F2 and group R2. Respiratory depression and vomiting occur more frenquently in group F2 and group R2. and there were more patients having pain of uterine contraction in group P,much more in group R1 and group R2 than in others. Recovery time from anesthesia is much short in group R1 and group R2. Conclusion Propofol with fentanyl or remifentanyl for induced abortion anesthesia may enhance analgesia and reduce the Propofol dosage. Big dosage can caurse respiratory depression and vomiting; Compared with remifentanyl, fentanyl has a good effection for removing pain of uterine contraction.