异丙酚复合芬太尼利多卡因用于无痛人工流产的临床观察

目的　探讨异丙酚复合芬太尼、利多卡因用于无痛性人工流产 (下简称人流 )的麻醉效果 ,对宫缩的影响 ,及发生的并发症。方法　观察 ASA - 级早孕病人 3 2 6例。选用手背浅静脉静注给药 ,给药顺序 :2 %盐酸利多卡因 2 ml,芬太尼 0 .0 5mg～ 0 .1 mg,异丙酚量以病人睫毛反射消失 ,手术时不动为好 (一般为 2～ 3 mg/ kg)。术中监测 :SBP,DBP,MAP,HR,Sp O2 。结果　 2 62例病人 BP轻微下降 ,但都在临床可接受范围 ,仅 1例 SBP最低达 83 mm Hg,静注 5 mg麻黄素后迅速恢复正常。2 1例病人出现心动过缓 ,但多为一过性 ,仅 2例达 5 0次 / min,用 0 .2 5 mg阿托品静注处理后好转。Sp O2 轻微降低 ,一般不会低于 90 % ,托起下颌或面罩给氧能很快上升。对宫缩无明显影响。并发症有 :血压下降 2 62例 (占 80 .3 7% ) ,心动过缓 2 1例 (占 6.44% ) ,清醒后恶心、呕吐 3例 (占 0 .0 9% ) ,颈部红斑 5例 (占 1 .5 3 % ) ,短暂的呼吸变浅、呼吸暂停 7例 (占2 .1 5 % ) ,膈肌痉挛 2例 (占 0 .0 6% ) ,清醒期和苏醒后短暂的兴奋躁动现象 5例 (占 1 .5 3 % ) ,异丙酚注射痛 2 9例 (占8.89% )。结论　异丙酚、芬太尼、利多卡因复合用于无痛人流效果确切 ,安全系数高 ,并发症轻且消失快 ,对宫缩无明显影响

Clinical Observation of Isopropyl Phenol CombinedFentanyl and Lidocaine for Painless Artificial Abortion

Objective To discuss the anesthesia effect of isopropyl phenol combined fentanyl and lidocaine for painless artificial abortion, and the medicine how to affect the uterine contraction and its complication Methods 326 cases of ASA Ⅰ Ⅱ grade early pregnancy were observed The dorsum of hands were chosen for dosing The dosing sequence: 2% lidocaine hydrochloride 2 ml, fentanyl 0.05 mg～0.1 mg, isopropyl phenol dosage 2～3 mg/kg The intraoperative monitored indexes were SBP, DBP, MAP, HR, SpO 2 Results 262 cases BP slightly decreased, only 1 case SBP decreased to 83 mmHg After given ephedrine 5 mg, the case SBP recovered to nomal 21 cases occurred transient bradycardia 2 cases heart rate decreased to 50/min Being injected atropine 0.25 mg IV, the sympton disappeared SpO 2 slightly decreased and quickly was recovered with uplifting mandible or offering oxygen Uterine contraction was not affected Complication was following: fall of blood pressure for 262 cases (80.37%), bradycardia for 21 cases (6.44%), nausea and vomiting for 3 cases (0.09%), cervical part erythema 5 cases (1.53%), transient hypopnea and apnea for 7 cases (2.25%), phrenoparalysis spasm 2 cases (0.06%), excitation and restlessness for 5 cases (1.53%), isopropyl phenol injection pain for 29 cases (8.89%) Conclusion The effect of isopropyl phenol combined fentanyl and lidocaine for painless artificial abortion is definite Safety factor is high Complication is slight and disappears quickly Uterine contraction isn't affected