不同药物用于人工流产术麻醉的比较  

Comparison of anesthetic effects of different anesthetics in induced abortion

作　　者：张勇[1] 梁淑芹[2] 

机构地区：[1]陕西省安康市中医院麻醉科,陕西安康725000 [2]陕西省委党校门诊部,陕西西安710061

出　　处：《中国妇幼健康研究》2008年第5期460-462,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的观察异丙酚分别伍用芬太尼?氯胺酮?曲吗多?瑞芬太尼在人工流产术麻醉时的临床效果及对呼吸循环的影响。方法150例人工流产孕妇,随机分为单纯异丙酚组(Ⅰ组)、复合芬太尼组(Ⅱ组)、复合氯胺酮组(Ⅲ组)、复合曲吗多组(Ⅳ组)、复合瑞芬太尼组(Ⅴ组),Ⅱ、Ⅲ、Ⅳ、Ⅴ组于异丙酚静注前分别给予芬太尼0.8μg/kg、氯胺酮0.4m g/kg、曲吗多1.5m g/kg、瑞芬太尼0.4μg/kg,观察异丙酚用量、麻醉效果及对呼吸循环的影响。结果Ⅰ组用药1分钟后血压、心率明显下降(P<0.01),Ⅱ、Ⅲ、Ⅳ、Ⅴ组异丙酚用量明显较Ⅰ组减少(P<0.01),且麻醉效果优于Ⅰ组。无人工流产综合征病例发生,各组出血量及宫颈松弛度比较均无显著差异。结论芬太尼、氯胺酮、曲吗多、瑞芬太尼均可提高异丙酚的麻醉效能,减少异丙酚的用量,可防止人工流产综合征的发生。Objective To observe anesthetic effects of diprivan combined with either fentanyl or ketamine or qvmaduo or remifentanyl in induced abortion and influences of the anesthetics on respiration and circulation of the women. Methods 150 pregnant women who expected to receive induced abortion were divided into five groups randomly： single diprivan group （group Ⅰ ）, diprivan combined with 0.81μg/kg of fentanyl group（ group Ⅱ ）, diprivan combined with 0.4mg/kg of ketamine group （ group Ⅲ）, diprivan combined with 1.5mg/kg of qvmaduo group （group Ⅳ ）, diprivan combined with 0.41xg/kg of remifentanyl group （ group Ⅴ ）. The dosage of diprivan, anesthetic effects and impacts of the anesthetics on respiration and circulation of the women were observed. Results Blood pressure and heart rate were significantly lowered from the first minute after diprivan infusion in group Ⅰ （ both P 〈 0. 01 ）. The dose of diprivan was much less and the anesthetic effect was much better in groups Ⅱ , Ⅲ, Ⅳ and Ⅴ than that in group Ⅰ （ all P 〈 0.01 ）. No women with artificial abortion syndrome were seen. In amount of vaginal hemorrhage and laxity of the cervix, there were no significant differences between the five groups. Conclusion Fentanyl, ketamine, qvmaduo and remifentanyl all can increase anesthetic effect of diprivan and decrease dose of diprivan. Also, they can prevent development of artificial abortion syndrome.

关 键 词：异丙酚 芬太尼 氯胺酮 曲吗多 瑞芬太尼 人工流产 麻醉 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R614