丙泊酚并小剂量芬太尼或舒芬太尼用于人工流产效果

目的比较丙泊酚复合小剂量芬太尼、舒芬太尼用于人工流产的麻醉效果。方法选择门诊ASAⅠ～Ⅱ级、自愿接受无痛人工流产手术的病人40例,随机分成丙泊酚复合芬太尼组（A组,n=20）和丙泊酚复合舒芬太尼组（B组,n=20）。A组于丙泊酚给药前缓慢静脉注射芬太尼0.6μg/kg,B组于丙泊酚给药前缓慢静脉注射舒芬太尼0.1μg/kg。比较两组病人用药前、后平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、脉搏氧饱和度（SpO2）,术中丙泊酚用量、病人意识消失和定向力恢复（用药结束至完全清醒）时间,术中呼吸抑制和术后发生宫缩痛的例数。结果B组用药后MAP、HR、RR高于A组,丙泊酚用量少于A组,差异均有显著性（t=2.043～7.430,P〈0.05）。A组5例病人术后发生宫缩痛,B组0例。两组病人SpO2和意识消失时间比较差异无统计学意义（P〉0.05）。B组定向力恢复时间明显短于A组（t=2.626,P〈0.05）。两组病人术中均无呼吸抑制。结论丙泊酚复合小剂量芬太尼或舒芬太尼用于无痛人工流产术都是安全有效的,舒芬太尼的镇痛效果优于芬太尼。

COMPARISON OF EFFECT OF PROPOFOL COMBINED WITH SMALL DOSAGE OF FENTANYL OR SUFENTANYL ON INDUCED ABORTION

Objective To compare the effect between propofol combined with small dosage of fentanyl or sufentanyl on induced abortion. Methods Forty patients, ASA physical status Ⅰ -Ⅱ , undergoing induced abortion, were evenly randomized to fentanyl-propoful group （group A） and sufentanyl-propofol group （group B）. 0. 6 μg/kg fentanyl was slowly injected before propoful injection in group A; 0.1 μg/kg sufentanyl was slowly injected before propofol injection in group B. The mean artery pressure （MAP）, heart rate （HR）, respiratory rate （RR） and pulse oxygen saturation （SpO2） were recorded, the total propofol dosage used, the time of loss of consciousness and its recovery time of orientation were recorded, respiration inhibited by drugs during procedures and pain of uterus contraction after operation were recorded. Results MAP, HR and RR after injection of drugs in group B were higher than that in group A （t=3. 071-7. 430,P〈0.05）, the total propofol dosage used in group J3 was less （t= 2. 043,P〈0.05）. There were five cases with contraction pain in group A, none in group B. No significant difference in SpO2 and the time of loss of consciousness between two groups （P〉0.05）. The recovery time of orientation in group B was less than that in group A （t=2. 626,P〈0.05）. No respiratory inhibition was encountered in both groups. Conclusion Propufol combined with small close of fentanyl or of sufentanyl are safe and effective for induced abortion, but sufentanyl is superior to fentanyl in pain relief.