依托咪酯乳剂在门诊人工流产术中的应用

目的 观察依托咪酯乳剂用于门诊无痛人工流产术的临床效果及对血流动力学的影响.方法 将门诊行人工流产手术患者40例按随机数字表法分为Ⅰ、Ⅱ 2组,每组20例.Ⅰ组给予依托咪酯乳剂 0.3 mg·kg-1静脉注射;Ⅱ组给予丙泊酚注射液 2.5 mg·kg-1静脉注射.观察2组注药前(T0)、注药后(T1)和苏醒后(T2)的SBP、DBP、HR、RR、SpO2的变化,麻醉诱导时间、苏醒时间、术中知晓及术中、术后的不良反应.结果 2组患者均顺利完成手术.Ⅰ组麻醉诱导、苏醒时间分别为(37.20±7.35)s和(5.38±2.05)min;Ⅱ组麻醉诱导、苏醒时间分别为(36.40±8.16)s和(5.22±2.12)min,2组比较差异均无统计学意义(均P＞0.05).与T0比较:Ⅰ组T1、T2及Ⅱ组T2时SBP、DBP、HR、RR均无明显变化(均P＞0.05);Ⅱ组T1时SBP、DBP、HR、RR均明显降低(均P＜0.05).与Ⅰ组比较:Ⅱ组T1时的SBP、DBP、HR均明显降低(均P＜0.05).Ⅰ组4例出现肌阵挛,1例注射部位疼痛;Ⅱ组9例出现注射部位疼痛.2组患者均无明显SpO2下降,无术中知晓及人流综合征发生.结论 依托咪酯乳剂具有对血流动力学影响小、并发症少的特点,可以安全地用于门诊无痛人工流产术的短时静脉麻醉.

Application of Etomidate in Lipid Emulsion in Artificial Abortion

Objective To investigate the effects of etomidate in lipid emulsion on painless artificial abortion and hemodynamics.Methods Forty patients undergoing artificial abortion were divided into two groups,with 20 patients in each group.Patients in group-I were intravenously anesthetized with etomidate in lipid emulsion（0.3 mg·kg-1） and patients in group-Ⅱ with propofol（2.5 mg·kg-1）.SBP,DBP,HR,RR and SpO2 were measured before and after injection,as well as after awakening.Anesthetic induction time,recovery time,awareness during anesthesia and adverse events were also investigated.Results Compared with the values before injection,the values for SBP,DBP,HR and RR did not changed significantly in group Ⅰ after injection and awakening（P0.05）,while reduced obviously in group Ⅱ after injection（P0.05）.It was also found that SBP,DBP,HR and RR reduced significantly in group-Ⅱ,compared with those in group-I（P0.05）.There were no obvious differences in anesthetic induction time and recovery time between the two groups[（37.20±7.35）seconds vs（36.40±8.16）seconds and（5.38±2.05）minutes vs（5.22±2.12）minutes,respectively].Among patients in group-Ⅰ,myoclonus occurred in 4 patients and injection site pain in 1 patients.Among patients in group-Ⅱ,injection site pain occurred in 9 patients.No obvious reduction in SpO2 was observed,and no abortion syndrome and awareness during anesthesia occurred in both groups.Conclusion Etomidate in lipid emulsion has little influence on hydrodynamics,and can be used safely in painless artificial abortion with fewer complications.