氟比洛芬酯复合丙泊酚与芬太尼用于无痛人流术

目的 评估氟比洛芬酯复合丙泊酚与芬太尼用于人工流产术中及术后的镇痛效果.方法 ASA I～Ⅱ级行无痛人流术的孕妇80例,随机分为A、B2组,每组40例,A组预先给予氟比洛芬酯,B组给予安慰剂(脂肪乳),2组均用丙泊酚复合芬太尼静脉麻醉.观察2组麻醉诱导前、意识消失时、扩宫结束时、苏醒时的HR、MAP、SpO2,记录丙泊酚用量、手术时间、苏醒时间、不良反应及术中麻醉效果,并应用VAS评分评估2组患者清醒后5、15和30 min时的疼痛程度.结果 与麻醉诱导前相比,2组在意识消失时、扩宫结束时HR、MAP下降(P均＜0.05),且A组MAP波动幅度明显低于B组(P均＜0.05)；2组各时间点SpO2差异无统计学意义(P均＞0.05).A组术中镇痛达优率稍高于B组,但差异无统计学意义.丙泊酚用量A组少于B组(P＜0.05)；患者苏醒后15、30 min时,A组VAS评分均明显低于B组(P ＜0.05,P＜0.01);2组手术时间、苏醒时间差异无统计学意义.结论 氟比洛芬酯复合丙泊酚与芬太尼可以安全有效地用于人工流产术的术中、术后镇痛.

Clinical evaluation of flurbiprofen axetil combined with propofol and fentanyl for painless artificial abortion

Objective To evaluate the intraoperative and postoperative analgesic effect of flurbiprofen axetil combined with propofol and fentanyl in painless artificial abortion.Methods Eighty pregnant women(ASAⅠ-Ⅱgrade)undergoing painless artificial abortion were randomly divided into two groups(n=40 each):test group(group A) and control group(group B).Flurbiprofen axetil(group A)or placebo(fat emulsion)(group B) were intravenously administered before operation,and then propofol plus fentanyl were used for intravenous anesthesia in two groups.Heart rate(HR),mean arterial pressure(MAP)and percutaneous oxygen saturation of blood(SpO2) were observed before anesthesia inducement,at loss of consciousness and after dilating cervix uteri and awaking.Total doses of propofol,operative time,waking time,adverse reactions and intraoperating analgesic effect were recorded,respectively.Visual analog scale(VAS) were used for evaluating the degrees of pain at 5,15 and 30min after waking.Results Compared with before anesthesia inducement,MAP and HR at loss of consciousness and after dilating cervix uteri were significantly decreased in both group A and group B(all P<0.05),and the fluctuating range of MAP in groups A was lower than that in group B(all P<0.05).There was no difference of SpO2 at each time point between two groups.The rate of achieving excellent analgesia in group A during the operation was slightly higher than that in group B,but there was no statistical difference between two groups(P>0.05).The dose of propofol in group A was less than that in group B(P<0.05).The VAS scores at 15min and 30 min after waking in group A were lower than those in group B(P<0.05,P<0.01).There were no differences in operation time and waking time between two groups.Conclusions Flurbiprofen axetil combined with propofol and fentanyl can effectively and safely relieve intraoperating and postoperating pain for painless artificial abortion.