右美托咪定与芬太尼复合丙泊酚用于无痛人流的麻醉效果比较研究

目的比较盐酸右美托咪定注射液与枸橼酸芬太尼注射液复合丙泊酚注射液用于无痛人流的麻醉效果。方法选取2015年12月—2016年6月在天津医科大学总医院滨海医院进行无痛人流术的患者200例,按照麻醉方式的不同分为对照组(113例)和治疗组(87例)。对照组静脉泵注枸橼酸芬太尼注射液,1μg/kg稀释至20 m L,泵注时间8 min。治疗组静脉泵注盐酸右美托咪定注射液,0.5μg/kg稀释至20 m L,泵注时间8 min。而后两组以1 m L/6 s静脉注射丙泊酚注射液。观察两组麻醉效果,比较两组的手术时间、苏醒时间、丙泊酚用量、心率(HR)、平均动脉压(MAP)、血氧饱和度(Sp O2)和不良反应。结果治疗后,对照组和治疗组的麻醉的优良率分别为74.34%、89.66%,两组比较差异有统计学意义(P0.05)。在术中,治疗组丙泊酚用量显著低于对照组,两组比较差异有统计学意义(P0.05)。在注射丙泊酚后(T2)、扩宫时(T3)、刮宫时(T4)时,两组HR和MAP水平明显低于同组泵注右美托咪定或芬太尼后注射丙泊酚前(T1)时,同组比较差异有统计学意义(P0.05);且在T3、T4时,治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。对照组和治疗组的不良反应发生率分别为32.74%、13.79%,两组比较差异有统计学意义(P0.05)。结论盐酸右美托咪定注射液复合丙泊酚注射液用于无痛人流的麻醉效果优于枸橼酸芬太尼注射液复合丙泊酚注射液,可减少丙泊酚用量,改善术中HR和MAP水平,安全性较好,具有一定的临床推广应用价值。

Comparative study on dexmedetomidine and fentanyl combined with propofol for anaesthesia in painless abortion

Objective To compare the effect of Dexmedetomidine Hydrochloride Injection and Fentanyl Citrate Injection combined with Propofol Injection for anaesthesia in painless abortion. Methods Patients (200 cases) in painless induced abortion in Binhai Hospital of General Hospital Affiliated to Tianjin Medical University from December 2015 to June 2016 were enrolled in this study. According to the difference anesthesia mode, patients were randomly divided into the control group (113 cases) and the treatment group (87 cases). Patients in the control group were intravenous pump injection administered with Fentanyl Citrate Injection, 1 μg/kg diluted to 20 mL, pump injection for 8 min. Patients in the treatment group were intravenous pump injection administered with Dexmedetomidine Hydrochloride Injection, 0.5 μg/kg diluted to 20 mL, pump injection for 8 min. Then patients in two groups were iv administered with Propofol Injection, infusion rate 1 mL/6 s. After treatment, the clinical efficacies were evaluated, and operation time, awakening time, propofol dosage, HR, MAP, SpO2, and adverse reactions in two groups were compared. Results After treatment, the excellent rate of anesthesia in the control and treatment groups were 74.34% and 89.66%, respectively, and there was difference between two groups (P < 0.05). During the operation, the propofol dosage in the treatment group was significantly lower than that in the control group, and there was difference between two groups (P < 0.05). At T2, T3, and T4, the levels of HR and MAP in two groups were significantly lower than those at T1, and there were difference in the same group (P < 0.05). And at T3 and T4, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). The incidence of adverse reaction in the control and treatment groups were 32.74% and 13.79%, respectively, and there was difference between two groups (P < 0.05). Conclusion The anesthetic effect of Dexmedetomidine Hydrochloride Injection combined with Propofol Injection in painless induced abortion is better than that of Fentanyl Citrate Injection combined with Propofol Injection, can reduce propofol dosage, and improve the levels of HR and MAP, with good safety, which has a certain clinical application value.