芬太尼滴鼻复合丙泊酚在人工流产术中麻醉效果观察

目的探讨芬太尼滴鼻用于人工流产术的安全性和有效性。方法60例美国麻醉医师协会（ASA）分级Ⅰ或Ⅱ级，年龄20～40岁，体重40～65kg，随机均分为两组，芬太尼稀释至2mL：观察组（A组）经鼻滴入芬太尼1μg/kg；对照组（B组）静注芬太尼1μg/kg。患者用药2min后均静注丙泊酚1．5～2mg／kg，患者意识消失即开始手术，酌情追加丙泊酚0．5～1mg／kg。记录用药前（T0）、用药后2min（T1）、静注丙泊酚后1min（T1）、2min（T3）及清醒时（L）的平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2）、丙泊酚用量、诊疗时间、意识恢复时间、术后恶心、呕吐、嗜睡发生情况。结果MAP两组在T1～T4时均低于L时（P〈0．05），组间比较无统计学意义，SpO2在T2、B时A组低于B组（P〈0．05），B组T1～T3时低于T0时（P〈0．05）；丙泊酚用量两组差异无统计学意义。结论1μg/kg芬太尼滴鼻复合丙泊酚静注用于人工流产术是安全有效的。

The Observation of Intranasal Fentanyl Combined with Propofol Anesthesia for Abortion

Objective To investigate the effectiveness and safety of intranasal fentanyl combined with propofol anesthesia for abortion. Methods Sixty patients （ ASA Ⅰ or Ⅱ ） aged 20 - 40 years, weighted 40 - 65 kg, were randomly divided into two groups of 30 cases each. The fentanyl were diluted to 2 ml： observer group （groupA） for fentanyl 1 μg/kg were trickled in nasal; control group （group B） for fentanyl 1 μg/kg were infused by intravenous. After 2 minutes, propofol 1.5-2 mg/kg were infused by intravenous, when the patient lost consciousness, doctor began to surgery, additional propofol 0. 5 - 1 mg/kg if it was need. MAP, HR, SpO2 were recorded before medication （ T0 ）, 2 min after medication （ T1 ） , 1 min after intravenous propofol （ T2 ） , 2 min after intravenous propofol （ T3 ） and awakening （ T4 ） , recorded propofol dosage, treatment time, consciousness recovery time, postoperative nausea, vomiting and drowsiness. Results MAP in all time points in two groups were lower than baseline （ P 〈 0. 05 ） ; SpO2 at T2 - T3 in group B were lower than same time points of groupA （ P 〈 0. 05 ）, SpO2 of T1- T3 were lower than TO in group Ⅱ （ P 〈 0. 05） ; Propofol difference was not statistically significant. Conclusions 1 μg/kg intranasal fentanyl combined with propofol intravenous injection is safe and effective for abortion.