丙泊酚配伍不同镇痛药用于人工流产的临床观察  

Clinical Observation of Propofol with Different Narcotics in Artificial Abortion

作　　者：张玉龙[1] 范志明[1] 曹锦芳[1] 李月光[1] 

机构地区：[1]江苏省常州市第四人民医院麻醉科,江苏常州213001

出　　处：《海南医学》2005年第11期34-35,共2页Hainan Medical Journal

摘　　要：目的观察丙泊酚配伍曲马多或芬太尼用于人工流产术的麻醉效果及安全性。方法108例自愿接受人工流产患者随机分为A、B、C三组,每组36例,A组单纯静注丙泊酚2mg/kg,B、C组先分别静注曲马多1.0mg/kg和芬太尼1μg/kg,30秒后均静注丙泊酚2mg/kg。记录患者MAP、HR、SpO2、RR的变化;记录患者诱导及苏醒时间、丙泊酚总用量及术中呼吸抑制等情况。结果A组麻醉后1min、3min的MAP、HR较麻醉前降低且差异性显著(P<0.01),B、C组MAP、HR则无明显变化(P>0.05),B、C组诱导及苏醒时间明显短于A组,B组和C组丙泊酚总用量较A组明显减少(P<0.01)三组患者均有不同程度呼吸抑制,其中以C组最为严重,与A组比较差异性显著(P<0.05),A组有25例患者术中出现体动反应,与B、C组比较差异性显著(P<0.01)。结论丙泊酚配伍曲马多或芬太尼用于人工流产术,均能提高麻醉镇痛效果,减少丙泊酚的用量,缩短诱导及恢复时间,但芬太尼和曲马多均可增加丙泊酚的呼吸抑制作用,故麻醉中要加强生命体征监测和呼吸管理。Objective To observe the effect and safety of propofol anesthesia with tramadol or fentanyl in artificial abortion. Methods 108 cases of volunteers received artificial abortion were randomly divided into three groups （group A and B and C）, each group was 36 cases. Group A was administrated propofol 2mg/kg only; After group B and group C were administrated tramadol lmg/kg and fentanyl 1μg/kg respectively, propofol 2mg/kg was administered in two groups 30 second after. MAP, HIL SpO2, RR, induction time, recovery time, the dosage of prepofol and respiration depression were recorded. Results MAP and HR decreased dominantly at 1 and 3 rain after patients undergoing anaesthesia with propofol（P〈0.01） in group A, MAP and HR between group A and B had no significant difference（P〉0.05）, induction time and recovery time in group B and C were shorter significantly than that in group A. Propofol dosage in group B and C was less than that in group A（P〈0.01）. Three groups all had different degree respiration depression, respiration depression occurrence of group C was higher dominantly than that of group A （P〈0.05）.The stress response to Artificial Abortion could be attenuated more effectively in group B and C than that in group A. Conclusions Propofol combined with tramadol or fentanyl in artificial abortion can enhance analgesia and reduce the propofol dosage and shorten induction time and recovery time.

关 键 词：曲马多 芬太尼 丙泊酚 人工流产术 

分 类 号：R971.2[医药卫生—药品]