瑞芬太尼在无痛人工流产术中的应用

目的:探讨瑞芬太尼复合异丙酚在人工流产中的应用效果。方法:180例早孕妇女随机分成3组,2组人工流产术中分别应用瑞芬太尼复合异丙酚、利多卡因,另1组为对照组,不采用任何干预措施。观察3组的镇痛效果、人工流产综合征(PAAS)发生率、宫口松弛情况及出血量,并观察瑞芬太尼复合异丙酚组BP、SPO2、HR、RR变化、手术时间、苏醒时间、镇痛评分、定向力恢复、术后VSA评分及副反应。结果:瑞芬太尼复合异丙酚组镇痛效果明显,与利多卡因组、对照组比差异有显著性(P<0.05);且苏醒早,术后血压、心率、呼吸无明显变化,出血量与对照组、利多卡因组比较差异无显著性。结论:瑞芬太尼复合异丙酚麻醉效果可靠,适合于门诊无痛人工流产麻醉的要求,但必须注意术中严密观察监测呼吸和心率,并缓慢推注以减少呼吸抑制和心动过缓的发生。

The Application of Remifentanil in Induced Abortion

Objective:To compare the anesthetic effect rofemifentanil-propofol and lidocaine in induced abortion.Methods:180 early pregnant women,undergoing induced abortion were randomly allocated into 3 groups,vein injection of remifentanil and propofol as group A;para-cervix block by lidocaine as group B;without any anesthetic intervention as group C.The effect of pain relieves,the rate of PAAS,the dilation of cervix and the volume of bleeding were analyzed.BP,SPO_2,HR,RR,duration of operation,time of recovery,score of pain relief,recovery of direction,score of VSA and side effects were recorded.Results:remifentail-propofol group has the characters of fast effect,significant pain relief,and early recovery,which are better than other two groups.There are no differences of the other parameters in all groups.Conclusions:Remifentail combined with propofol is a reliable anesthesia,suitable for induced abortion,but the patients must be monitored intensely during the operation,slow down the injective speed can prevent the occurrences of respiratory inhibition and bradycardia.