丙泊酚复合氟比洛芬酯在人工流产手术麻醉中的应用

目的：研究丙泊酚复合氟比洛芬酯用于人工流产手术的麻醉作用。方法：ASA分级Ⅰ～Ⅱ人工流产患者80例，随机均分为4组，Ⅰ组先缓慢静脉注射芬太尼1μg／kg，10min后静脉注射丙泊酚2mg／kg；Ⅱ组先静脉注射曲马多1mg／kg，10min后静脉注射丙泊酚2mg／kg；Ⅲ组先静脉注射氟比洛芬酯50mg，10min后静脉注射丙泊酚2mg／kg；Ⅳ组静脉注射丙泊酚2mg／kg。四组丙泊酚静注速率均为100mg／min。观察各组诱导及苏醒时间、用药总量，记录术中呼吸、循环参数改变和术中、术后不良反应。术后由手术医生评定麻醉效果。结果：手术全程丙泊酚给药量及术毕至唤醒时间对照组高于其他各组。Ⅰ组术中最低SpO2值在85％～90％之间或小于85％的病例均多于其他组（P〈0．05），Ⅰ，Ⅱ组术中舌根后坠、术后恶心、呕吐发生率高于Ⅲ和Ⅳ组，Ⅳ组苏醒期兴奋躁动的发生率高于其他各组。麻醉效果达优者以Ⅳ组最少。术后下腹痛VAS评分0—2分者Ⅲ组优于其他组。结论：丙泊酚复合氟比洛芬酯用于人工流产手术的麻醉中不但可获得较为满意的麻醉效果，而且药物不良反应少，对术后下腹痛也表现出更好的镇痛效果，是一种有效的配伍方法。

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OBJECTIVE: To observe the effect of propofol combined with flurbiprofen axetil for abortion anesthesia. METHODS: Eighty ASA I - II induced abortion patients were randomly divided into 4 groups. Group I was administrated 1 microg/kg with tramadol first, after 10 minutes with 2 mg/kg propofol. Group II was administrated with 1 mg/kg tramadol first, after 10 minutes with 2 mg/kg propofol. Group III was administrated flurbiprofen axetil 50 mg first, after 10 minutes 2 mg/kg propofol. Group IV was administrated propofol 2 mg/kg. The speed of intravenous injection of propofol was 100 mg/min in all groups. Induction time, recovery time, propofol dosage, HR, BP, SpO2, and side effect were recorded. The anesthesia effect was judged by operation doctors. RESULTS: Propofol consumption and awaken time in Group IV was more than those of other groups. The number of patients in Group I with minimum value of SpO2 in the operation (85% - 90% or SpO2<85%) was higher than that of other groups (P<0.05). The number of patients in Group I and II with the tongue falling backwards during anesthesia, with post-anesthesia nausea and vomit was higher than that of other groups (P<0.05). Incidences of post-anesthesia excitement or delirium were higher than other groups. Fewer patients in Group IV showed a good level anesthesia effect than other groups. The post-operative hypogastric pain of VAS score (0 - 2) in Group III was better than others. CONCLUSION: Propofol combined with flurbiprofen axetil gives more efficient anesthesia for induced abortion patients in gynecology department. It can not only have satisfactory anesthesia effect, but also decrease adverse effects and obtain better depression effects to the post-operative hypogastric pain.