丙泊酚配伍芬太尼和瑞芬太尼静脉麻醉在无痛人工流产术中的比较

目的 评价丙泊酚联合芬太尼、瑞芬太尼应用于无痛人工流产术的效果及安全性.方法 将52例无痛人工流产患者随机分成两组,每组26例.F组:丙泊酚2 mg/kg联合芬太尼1 μg/kg,R组:丙泊酚2 mg/kg联合瑞芬太尼1 μg/kg.观察两组患者的平均动脉血压(MAP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2)的变化及苏醒时间、术中知晓、呼吸抑制、麻醉效果、丙泊酚用量、术后宫缩痛VAS评分等指标.结果 两组术中MAP、HR、RR与术前相比均有显著性降低(P＜0.05),两组患者之间无显著性差异(P＞0.05),术中SpO2与术前相比无显著性变化(P＞0.05).瑞芬太尼组苏醒时间比芬太尼组明显缩短(P＜0.05),且术中呼吸抑制发生率明显低于芬太尼组(P＜0.05),但术后宫缩痛VAS评分比芬太尼组明显增高(P＜0.05).两组麻醉效果无显著性差异(P＞0.05).两组丙泊酚用量无显著性差异(P＞0.05).两组均未发生术中知晓.结论 瑞芬太尼和芬太尼与丙泊酚联合均能有效应用于无痛人流术.但是瑞芬太尼术中呼吸抑制少,术后苏醒快,而芬太尼术后止痛效果好.

The comparision of propofol combined with fentanil or remifentanil in painless artificial abortion

Objective To investigate the effects and the security of propofol combined with fentanil or remifentanil in painless artificial abortion. Methods 52 women with a pregnant duration of 40~60 days and an ASA gradeⅠ~Ⅱ,who volunteered to received a painless artifical abortion, were randomly divided to two groups(n=26). The group F were given intravenous injection of propofol 2 mg/kg and fentanil 1 μg/kg.The group R were given propofol 2 mg/kg and remifentanil 1 μg/kg. The HR,RR,MAP,SpO2 and awakening time,Intraoperative awareness,respiratory depression,the VAS of contraction pain,the total dosage of propofol were observed. Results HR,RR,MAP and SpO2 were no statistically different between group F and group R, but HR,RR and MAP were lower than those before surgery.SpO2 was no statistically different before and after surgery. The awakening time in group R were shorter than that in group F,and the rate of respiratory depression in group R were lower than in group F.But the VAS of contraction pain in group R were higher than in group F.The anesthetic effect and the total dosage of propofol were no statistically significant difference in two groups. Intraoperative awareness were not occurred in both groups.Conclusion Both fentanil and remifentanil in combination with propofol can be effectively applied in artifical abortion,with a faster awakening time and less respiratory depression by remifentanil and a more satisfactory postoperative analgesia effect by fentanil.