异丙酚对无痛人流效果的综合评价

目的探讨异丙酚用于无痛人流手术中对病人的影响。方法观察30例无痛人流患者，微量泵静注方式泵人异丙酚，首次剂量：1～2mg／kg·min，观察者不断给病人言语指令，待失去语言指令反应和睫毛反射消失时，定为意识消失；再以0．4～0．6mg／kg·min维持，术毕，停止静注异丙酚，恢复言语指令和睫毛反射时，定为意识恢复。分别监测清醒、意识消失及意识恢复时的数量化脑电图变化。术后随访了解病人在异丙酚全麻恢复即刻的回忆。除进行生命体征监护和麻醉深度监测外，还应用前臂隔离法、模糊辩听法及术后测试法等考查和比较异丙酚对术中高级神经活动进行干预时，除达到无痛效果外，对其意识活动的影响。结果术中无疼率100％；无意识活动100％；术前10～30min不能记忆85％；顺行遗忘（15±5）min；逆行遗忘（5±1）min；停药后苏醒时间为（7±3）min；自述有梦20％。结论异丙酚不仅对人流术中不适有良好的抑制，使会阴和宫颈松弛，病人合作便于操作，而且对人流过程中病人高级神经活动中的负面效应有较好纠正作用。更重要的是同术期遗忘对患者人流恐惧心理有一定的治疗效果。

Effects of Propofol on Painless Artificial Abortion

Objective To study the effects of propofol on painless artificial abortion. Methods 30 patients, undergoing painless artificial abortion, intravenously injected propofol with first dose of 1 - 2 mg/kg . min. by micro pump. The observer gave patients language instruction continuously. Loss of consciousness was confirmed when loss of language instruction reaction and eyelash reflex. The maintenance dose was 0.4 - 0.6 mg/kg min Injecting of propofol stopped at the end of operation. The conscious- ness recovery was confirmed when recovery of language instruction reaction and eyelash reflex. Changes of electroencephalogram was recorded during consciousness, loss of consciousness and recovery of consciousness. The effects of propofol on conscious activity were also detected by isolated forearm technique, fuzzy hearing and postoperative testing. Results The painless rate and unconsciousness in operation were both 100%. 85% patients had no memory in 10 - 30 mins before operation. The amnesia time was 15±5 mins. The time of retrograde forgetting was 5 ＋ 1 min. The awakening time after stopping drug was 7 ± 3 min. 20% patients claimed having dreams. Conclusion Propofol can not only inhibit the discomform of artificial abortion, make perineum and cervial relax, and make patient co-operate easily, but also has a good connective effect on bad effects of higher nervous activity.