丙泊酚复合氟比洛芬酯实施人工流产术30例临床观察

目的观察氟比洛芬酯复合丙泊酚用于人工流产术的麻醉效果及安全性。方法选择ASAⅠ或Ⅱ级人流孕妇90例，随机均分为三组各30例，A组：单纯使用丙泊酚2mg／kg；B组：先缓慢静脉注射芬太尼1μg／kg，10min后使用丙泊酚2mg／kg；C组：先静脉注射氟比洛芬酯50mg，10min后使用丙泊酚2mg／kg。三组静脉注射丙泊酚的速率均为80mg／min，必要时追加适量丙泊酚。连续监测HR，MAP，SbO2，记录睫毛反射消失时间、手术持续时间、术后苏醒时间、全程丙泊酚用量、术后2h镇痛效果及麻醉期间不良反应。结果B、C组术后苏醒时间和全程丙泊酚用量均少于A组（P〈0．05）。在睫毛反射消失时、丙泊酚给药2min及术毕各组HR、MAP、SpO2均降低（P〈0．05），B组SpO2显著低于A、C组（P〈0．05），术中SpO2在85％-89％及〈85％区段的发生率B组高于A、C组（P〈0．05）。B、C组术后2h镇痛优者高于A组（P〈0．05）。A、B组术后恶心呕吐发生率高于C组（P〈0．05）。A组苏醒期兴奋躁动发生率高于B、C组（P〈0．05）。B组呼吸暂停发生率高于A、C组（P〈0．05）。结论氟比洛芬酯复合丙泊酚用于人工流产术镇痛效果良好，且能减少丙泊酚用量，同时降低不良反应发生率。

Propofol combined with flurbiprofen in artificial abortion

Objective To evaluate the efficacy and safety of propofol combined flurbiprofen in artificial abortion. Methods 90 pregnant patients with ASA physical status Ⅰ - Ⅱ were reernited to the trial and randomly diided into three groups （group A, group B, group C）. Propofol 2 mg/kg was administered intravenously in group A; propofol 2 mg/kg was used 10 minutes after the administration of fentanyl 1 μg/kg in group B; flurbiprofen 50 mg was intravenously infused 10 minutes before the administration of propofol 2 mg/kg in group C. The infusion velocity of propofol was 80 mg/min in all groups and the dosage were added in accordance with clinical situation. HR, MAP and SpO2 were continuously monitored, the following parameters were recorded ： time of eyelash reflection deprivation,duration of surgery, time of wake- up, total dosage of propofol, 2 hours postoperative analgesic effect and side effects during anesthesia. Results As for total dosage of propofol and time of wake - up, group B and C significantly less than group A （ P 〈 0.05 ）. In contrast with pre - anesthetic value, HR, MAP, SpO2 markedly decreased in time of eyelash reflection deprivation and 2 min after propofol administration. The rate of SpO2 in 85% - 89% and below 〈85% was more frequent in group B than that in group A and C（ P 〈0.05）. The analgesic effect in group B and C was superior to that in group A after 2 hours of operation（ P 〈 0.05 ）. The rate of postoperative nausea and vomiting was higher in group A and B than that in group C （ P 〈 0. 05 ）. The rate of excitation and restless was more in group B and C than that in group A （ P 〈 0.05 ） and respiration apnea was easily occurred in group B （ P 〈 0.05 ）. Conclusion Propofol in conjunction with flurbiprofen produces good analgesic effect in artificial abortion and reduces the amount of propofol and perioperative adverse reactions.