布托啡诺复合丙泊酚用于无痛人流的疗效观察

目的对比观察布托啡诺与芬太尼联合丙泊酚用于无痛人流术的镇痛效应及不良反应,旨在比较观察布托啡诺和芬太尼用于人工流产术的临床效果和安全性。方法 300例拟行无痛人流的初孕妇女,随机分为三组：布托啡诺组（A组）、芬太尼组（B组）,单纯丙泊酚组（C组）。A组布托啡诺10μg/kg＋丙泊酚2.0 mg/kg静脉注射,B组：静脉注入芬太尼0.05 mg＋丙泊酚2.0 mg/kg,C组丙泊酚2.0 mg/kg静脉注射,三组均匀速推注丙泊酚,待意识消失后施术。术中视情况追加丙泊酚20-50 mg。连续观察HR、SBP、DBP、SpO2,以及麻醉时间,麻醉恢复时间,丙泊酚用量和副作用。结果 A、B两组丙泊酚用量及麻醉效果（优秀率）相似（P〉0.05）,麻醉时间、SpO2最低值无明显差别,而麻醉恢复时间A组明显延长（P〈0.01）。C组丙泊酚用量最多,血流动力学变化最为显著（p〈0.01）。结论与单纯丙泊酚相比,布托啡诺联合丙泊酚更能满足无痛人工流产手术的麻醉要求,副作用少,丙泊酚用量减少,呼吸抑制轻。但与芬太尼组相比其苏醒时间略长,增加了观察时间。

Curative effect of butorphanol combined with propofol on abortion without pain

Objective： To compare the effect of butorphanol and fentanyl in combination with propofol used on abortion without pain.Methods： Three hundred patients were randomly divided into the three groups（n=100 each）： butorphanol group（A）,fentanyl group（B）and propofol group（C）.After butorphanol 10ug/kg,propofol 2.0mg/kg was given intravenously in Group A;after fentanyl 0.05mg,propofol 2.0mg/kg was given in Group B and propofol 2.0mg/kg alone in Group C.The operation began when the patient＇s consciousness disappeared.To boost propofol 20～50mg according to patient＇s reaction during the operation,HR,SBP,DBP and SpO2 were monitored before and during anesthesia.The time of anesthesia,recover time,the dosage of propofol and side effect were recorded.Results： The dosage of propofol and effect of anesthesia（rate of superiority）in group A and B were similar.There wasn＇t significant difference in anesthesia time and the nadir of SpO2,but the recover time of Group A was obviously extended than that of Group B（P〈0.01）.The dosage of propofol was the highest and the change of hemodynamics was the most significant in Group C（P〈0.01）.Conclusion： Butorphanol combined with propofol suit the abortion without pain better than propofol alone.Its side effct and dosage of propofol are small,moreover,its respiratory depression is slight.But compared with Group B,the recover time and the observation time in Group A is longer.