丙泊酚复合芬太尼麻醉在经阴道超声引导取卵术中的应用  

Intravenous propofol combined with fentanyl for anesthesia during ultrasound-guided transvaginal oocyte retrieval

作　　者：刘高望[1] 史永胜[1] 徐建设[1] 陈士岭[2] 陈英[1] 

机构地区：[1]南方医科大学南方医院麻醉科,广东广州510515 [2]南方医科大学南方医院妇产科,广东广州510515

出　　处：《第一军医大学学报》2004年第11期1304-1305,共2页Journal of First Military Medical University

摘　　要：目的观察丙泊酚或丙泊酚复合芬太尼静脉麻醉用于门诊经阴道超声引导取卵术的临床效果及安全性.方法100例接受经阴道超声引导取卵术(ASAⅠ～Ⅱ级)患者,随机分为A、B两组(n=50),分别给予丙泊酚或丙泊酚复合芬太尼麻醉.记录麻醉意识消失和苏醒时间、丙泊酚维持麻醉用量和平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2).结果意识消失时间A组为(58.8±3.8)s,B组为(57.7±5.2)s,无显著差异(p=0.283);苏醒时间A组为(6.0±0.6)min,B组为(5.7±0.4)min,有显著差异(P＜0.01).丙泊酚维持量B组为(0.20±0.03)mg/kg,显著低于A组的(0.52±0.05)mg/kg(P＜0.01).麻醉诱导后2min,A组MAP从(11.1±0.8)kPa降至(8.0±0.6)kPa(P＜0.05),B组MAP从(10.9±0.9)kPa降至(8.3±0.7)kPa(P＜0.05).A组麻醉诱导后26例(52%)SpO2降至90%以下,显著低于B组44例(88%)(P＜0.001).结论丙泊酚复合小剂量芬太尼可显著减少丙泊酚的维持量,缩短苏醒时间,有利于病人恢复及早期离院.Objective To compare the clinical efficacy and safety of anesthesia with intravenous propofol combined with fentanyl for ultrasound-guided transvaginal oocyte retrieval. Methods Totally 100 unpremedicated infertile women (ASA Ⅰ -Ⅱ ) scheduled for oocyte retrieval with ultrasound guidance were randomly divided into two groups to receive anesthesia with either intravenous propofol (group A, n=50) or the combination of propofol and fentanyl (group B, n=50). The time when consciousness loss and recovery occurred, dosage of propofol for anesthesia maintenance, mean arterial blood pressure (MAP), heart rate (HR) and oxygen saturation (SpO2) were recorded. Results There was no significant difference in the time of consciousness loss between groups A and B (58.8±3.8 s vs 57.7±5.2 s, P=0.283), but consciousness recovery occurred earlier in group B (6.0±0.6 min vs 5.7±0.4 min, P<0.01). The maintenance dosage of propofol in group B (0.20±0.03 mg/kg) was significantly lower than that in group A (0.52±0.05 mg/kg, P<0.01). At 2 min after anesthesia induction, the MAP decreased from 11.1±0.8 kPa to 8.0±0.6 kPa in group A (P<0.05), and from (10.9±0.9) kPa to (8.3±0.7) kPa in group B(P<0.05), and returned to normal within 2-3 min in both groups. The incidence of low SpO2 (<90%) was lower in group A than in group B ((52% vs 88%, P<0.001). Conclusion Anesthesia with propofol combined with fentanyl may reduce the maintenance dosage of propofol, shorten the time of consciousness recovery during oocyte retrieval with ultrasound guidance, and can be helpful for the patients' early recovery and discharge from hospital.

关 键 词：丙泊酚 芬太尼 麻醉处理 经阴道超声引导取卵术 用药剂量 

分 类 号：R614[医药卫生—麻醉学]