七氟烷联合舒芬太尼用于无痛人工流产的临床观察

目的比较七氟烷联合舒芬太尼以及异丙酚2种麻醉方案在无痛人工流产(以下简称人流)术中的效果。方法将100名早期妊娠、自愿无痛人流患者随机分为两组:异丙酚组和七氟烷联合舒芬太尼组,观察两组患者术前、术后血压、心率、血氧饱和度、镇痛效果及不良反应等的发生情况。结果两组患者年龄、体重、平均孕周无明显差异。两组术前血压、心率及血氧饱和度无差异,但术后异丙酚组收缩压和舒张压均下降,收缩压由术前的115.8 mm Hg降至术后的93.0 mm Hg,t=9.826,P=0.000;舒张压由71.6 mm Hg降至63.2 mm Hg,t=4.268,P=0.000;七氟烷联合舒芬太尼组血压变化无差异。七氟烷联合舒芬太尼组清醒时及术后1 h镇痛效果优于异丙酚组,视觉模拟疼痛评分(VAS)得分清醒时为2.0±0.7,术后1 h为3.1±0.6,均低于异丙酚组;术中体动及术后宫缩痛的发生率低于异丙酚组,分别为22.0%和28.0%。但麻醉起效、定向力恢复时间较异丙酚组延长,苏醒期躁动的发生率高于异丙酚组。结论七氟烷联合舒芬太尼的麻醉方案较异丙酚更适合无痛人流的手术要求,并能缓解无痛人流术后的不适。

Clinical observation of sevoflurane combined with sufentanil for painless artificial abortion

Objective] To compare the effect between two anesthetic plans of sevoflurane combined with sufentanil and propofol for painless artificial abortion.Methods]100 early pregnant women who voluntarily received painless artificial abortion were randomly divided into the propofol group and sevoflurane combined with sufentanil group.The preoperative and postoperative blood pressure,heart rate and blood oxygen saturation,analgesia effect and adverse reactions of two groups were observed.Results]There was no significant difference in age,body weight and average gestational weeks between two groups.The difference in preoperative blood pressure,heart rate and blood oxygen saturation between two groups was not significant.In propofol group,the systolic pressure reduced from 115.8 mm Hg before operation to 93.0 mm Hg after operation（t=9.826,P=0.000）,and the diastolic pressure reduced from 71.6 mm Hg before operation to 63.2 mm Hg after operation（t=4.268,P=0.000）.There was no significant difference in blood pressure between before and after operation in sevoflurane combined with sufentanil group.The analgesia effect in the awake state and 1 h after operation in sevoflurane combined with sufentanil group was better than that in propofol group.In sevoflurane combined with sufentanil group,the visual analog pain score（VAS） in the awake state and 1 h after operation was respectively 2.0±0.7 and 3.1±0.6,which was lower than that in propofol group.The incidence rate of intraoperative body movement and intraoperative uterine contraction pain in sevoflurane combined with sufentanil group was respectively 22.0% and 28.0%,which was lower than that in propofol group.The anesthetic onset time and orientation recovery time in sevoflurane combined with sufentanil group were longer than those in propofol group,but the incidence rate of restlessness during recovery was higher than that in propofol group.Conclusion]The effect of sevoflurane combined with sufentanil is more effective for painless artificial abortion than that of propofol,and can alleviate the discomfort after painless artificial abortion.