不同剂量喷他佐辛在无痛人工流产术中的应用

摘要:目的　观察不同剂量喷他佐辛复合异丙酚用于人工流产术的临床效果和安全性。方法 60例需行无痛人工流产术的早孕患者随机平均分成3组：单纯异丙酚(A组); 异丙酚复合0.2mg/kg喷他佐辛(P1组); 异丙酚复合0.4mg/kg喷他佐辛(P2组)，分别记录诱导前(T0)、诱导后2 min(T1)、苏醒时(T2)、苏醒后10min（T3）的 MAP、HR、RR、SPO2及异丙酚用药总量, 诱导时间、苏醒时间、术后疼痛评分。 结果　三组患者T1时间MAP、RR、SPO2与T0比较有显著性差异(P＜0.01)。P2组T2与T0比较RR、SPO2有显著性差异(P＜0.01) ；T1时间， P1组较A组及P1组RR、SPO2 明显偏高(P＜0.01) ； T2时间 P2组较A组RR、SPO2明显更低(P＜0.05) ，P2组较P1组SPO2明显较低(P＜0.05) ；三组患者T3时间点各项生命指标与T0比较无显著性差异；异丙酚总量三组间存在显著性差异（A>P1>P2）；意识恢复时间、患者注射痛和术后5minVAS评分P1、P2组均明显少于A组(P＜0.01)。 结论　0.2mg/kg和0.4mg/kg喷他佐辛复合异丙酚用于人工流产术,可明显减少丙泊酚用量,苏醒迅速，安全性较高，止痛效果好。

Different doses of pentazocine used in painless induced abortion

【Abstract】　Objective　 To investigate the effect and safety of total intravenous anaesthesia with different doses of pentazocine combined with propofol in painless induced abortion. Methods Sixty patients(ASAⅠ-II)of painless induced abortion were divided into three groups randomly with 20 patients in each group: Group A intravenous injectied propofol, Group P1 pentazocine 0.2mg/kg combined with propofol , Group P2 pentazocine 0.4mg/kg combined with propofol , MAP, HR,RR, SpO2 before Induction (T0) and at 2 min after injection propofol (T1), in recovery time (T2), at 10 min after recovery (T3) and total administered dose of propofol , induction time , recovery time, VAS score were recorded,. Results In three groups: MAP, RR and SPO2 decreased dramatically at T1 compared to those at T0 (P＜0.01). MAP,HR, RR and SPO2 were no significant difference at T3 compared to those at T0 .The RR,SPO2 decreased dramatically at T2 compared to those at T0 in the group P2 (P＜0.01).At T1,The RR,SPO2 of group P1 increased compared to those of group A (P＜0.01).At T2 : The RR,SPO2 of group P2 decreased compared to those of group A(P＜0.05),SPO2 of group P2 were less than those of group P1 (P＜0.05). The total administered dose of propofol were significant difference in three groups (A>P1>P2).The recovery time, VAS score and the injection pain were significant lower in group P1 and P2 than in group A . Conclusion The 0.2mg/kg and 0.4mg/kg dose of pentazocine were effective to decreased the total administered dose of propofol and the injection pain in painless induced abortion with safety and less recovery time.