丙泊酚联合小剂量地佐辛用于无痛人流术的效果观察

目的探讨丙泊酚联合小剂量地佐辛用于无痛人流术的镇痛效果及不良反应。方法 150例ASAⅠ～Ⅱ级早期妊娠患者随机均分为三组,每组50例。Ⅰ组:地佐辛5mg与1%丙泊酚复合静脉麻醉;Ⅱ组:芬太尼1μg/kg与1%丙泊酚复合静脉麻醉,Ⅲ组:单纯丙泊酚静脉麻醉。观察比较麻醉前后呼吸循环变化、诱导时间、苏醒时间、丙泊酚总用量、麻醉镇痛效果及不良反应。结果所有患者手术都成功完成。Ⅲ组T2、T3时MAP较Ⅰ、Ⅱ组明显升高(P<0.05);Ⅱ组T1、T2、T3时SpO2、HR较Ⅰ、Ⅲ组明显降低(P<0.05);Ⅲ组丙泊酚总用量明显多于Ⅰ、Ⅱ组(P<0.05);术中镇痛不全和术后子宫收缩痛发生率Ⅲ组显著高于其他各组(P<0.01);呼吸抑制发生率Ⅱ组显著高于Ⅰ、Ⅲ组(P<0.01);诱导时间、苏醒时间及不良反应的发生率三组无明显差异(P>0.05)。结论丙泊酚联合地佐辛用于无痛人工流产手术,镇痛效果确切,呼吸抑制小,安全性高,值得推广。

The Effects of Intravenous Propofol Anesthesia Combined with Small Doses of Dezocine in Painless Artificial Abortion

Objective To explore the analgetic and adverse effects of intravenous propofol anesthesia combined with small doses of dezocine in painless artificial abortion.Methods 150 early pregnancy women(ASA I ～ II) with painless artificial abortion were randomly divided into 3 groups:intravenous injection of dizocine 5 mg comnbined with 1% propofol in group I,intravenous injection of fentanyl 1 μg/kg followed by 1%propofol in group II,and intravenous injection propofol only in group III.The changes of respiratory and circulatory function,induction and revive time,total propofol dosages,analgesic and side effects were observed.Results The operations were successful in all patients.Compared with group I and II,the MAP of group III significantly increased at T2 and T3,the total dosage of propofol for group III were lower(P <0.05) ;Compared with group I and III,the SpO2 and HR significantly decreased at T1,T2 and T3 in group II(P <0.05) ;The intraoperative insufficient analgesia and postoperative abdominal pain incidence rates of patients in group III were higher than other groups significantly(P <0.01) ;The respiratory depression incidence rates of patients in group II were the highest in three groups(P <0.01) .There were no significant differences in the induction time,revive time and side-effects in all the patients(P <0.05) .Conclusion Intravenous propofol anesthesia combined with small doses of dezocine is safe and effective in painless artificial abortion.