布托啡诺合用丙泊酚静脉麻醉在无痛人工流产术中的应用

目的评价布托啡诺合用丙泊酚静脉麻醉在无痛人工流产术中的疗效和安全性。方法美国麻醉学会（ASA）I－Ⅱ级妊娠1－2个月自愿施行人工流产术的孕妇60例，随机分成治疗组和对照纽，每组各30例，对照组为单纯丙泊酚静脉麻醉，治疗组为布托啡诺1mg合用丙泊酚静脉麻醉。2组丙泊酚均采用2次推注法即首次给药至深镇静，2－3min后扩宫口时再追加50％诱导量。观察诱导过程及术中血压、心率、脉搏氧饱和度、呼吸频率、苏醒时间、丙泊酚用量、术后恶心呕吐（PPNV）、头晕、术后宫缩痛（采用VAS评分）。结果丙泊酚用量治疗组少于对照组（P〈0．05），呼吸抑制发生率对照组83％、治疗组50％（P〈0．05），术后宫缩痛治疗组明显少于对照组（P〈0．05）；两组术中血压、心率、脉搏氧饱和度比较差异无统计学意义。结论布托啡诺合用丙泊酚静脉麻醉行无痛人工流产术可以减少丙泊酚用量和呼吸抑制的发生，增强镇痛效果而不增加不良反应。

Effects of butorphanol as supplement to proprfol anaesia in painless induced abortion

Objective To evaluate efficacy and safety of butorphanol as supplement to propofol anaesthesia in painless induced abortion. Methods 60 ASA I - Ⅱ free will pregnant woraen undergoing painless induced abortion were enrolled and randomly divided into treatment group（ n = 30）and control group（ n = 30） .Pregnant stage was in the first or second months.In the control greup, patients were administrated intravenously prupofol alone;whereas in the treatment group, lmg butorphanol was used in combination with propofol. Both groups were infused intravenously by two phases,in first phase drug was used until patients were deeply sedated,in second phase （about 2-3 minuste later when uterocervical dilation）additional 50% inducing dosage was administrated. Blood pressure, heart rate, SpO2,breath freqnency, revival time, prupofol dosage,post-operative nausea and vomiting（PONV）, vertigo and postoperative uterotonic paln（adopt VAS grade）in two groups were compared in inducing and maintaining phases, Results Data of prupofol dosage, postoperative uterotonic pain and rate of breath inhibition in treated group were less than those in control group（ P 〈 0.05）.However, it was of no statistical significances in two groups for data of blood pressure, heart rate and SpO2. Conclusion Butophanor can reduce propofol dosage and respiratory inhibition rate,strengthen analgesia effect of propofol without more side effects when used as supplement to propofol