丙泊酚复合瑞芬太尼或芬太尼麻醉用于无痛人工流产临床观察

目的 比丙泊酚复合瑞芬太尼或芬太尼麻醉用于无痛人工流产的效果.方法 将200例择期自愿接受无痛人工流产的患者随机分为瑞芬太尼组(R组)和芬太尼组(F组),每组100例,R组静注瑞芬太尼1.0 μg/kg和丙泊酚1.0～1.5 mg/kg;F组静注芬太尼1.0μg/kg和丙泊酚1.0～1.5 mg/kg.记录丙泊酚用量、患者入睡时间、清醒时间及离院时间;记录麻醉前(基础值)、睫毛反射消失时、手术开始后1 min、3 min及手术结束时的BP、HR、血氧饱和度(SpO2);记录术中及术后的镇痛效果;记录术中发生的不良反应的例次数,如头晕、嗜睡和恶心.结果:R组丙泊酚用量显著少于F组[(80.4±10.8)mg与(110.1±13.6)mg,P＜0.01];与F组比较,R组入睡时间、清醒时间、离院时间缩短(P＜0.05);R组患者头晕、恶心和嗜睡的发生率均低于F组(P＜0.01);与F组比较,R组在给药后各时间点的SpO2下降明显(P＜0.05).结论 丙泊酚复合瑞芬太尼或芬太尼麻醉均能安全有效地实施无痛人工流产,但丙泊酚复合瑞芬太尼较丙泊酚复合芬太尼更适合于无痛人工流产.

Comparison of propofol-remifentail and propofol-fentanyl anesthesia for painless artificial abortion

Objective To observe and compare the efficacy and safety between propofol-remifentanil and propofol-fentanyl for anesthesia of artificial abortion.Methods 200 ASA I patients scheduled for painless artificial abortion were randomly divided into two groups.R group were given intravenous remifentanil 1.0μg/kg then propofol 1～1.5mg/kg(n=100);F group were given intravenous fentanyl 0.05mg then propofol 1～1.5mg/kg(n=100).Total propofol dosage,analgesic effect during intro-and post-operative,consciousness loss time,wake-up time and independenly leaving time were recorded.BP,HR,SpO2 and side effects such as nausea and vomiting were observed during intro-and post-operative.Results The dosage of propofol was less in group R than that in group F[(80.4±10.8)mg vs(110.1±13.6)mg,P＜0.01)];consciousness loss time,wake-up time and independenly leave hospital time were shorter in group R than that in group F(P＜0.05);SpO2 down range and rate were significandy higher in group R(P＜0.05);Incidence of nausea and somnolence in group R was obviously lesS than that in group F.Conclusion Artifical abortion can be preformed effectively and safely with propofol-remifentanil or propofol-fentanyl,but propofol-remifentanil especially fits for painless artificial abortion compared with propofol-fantanyl.