丙泊酚靶控输注在人工流产手术中的应用  

Application of propofol TCI combined with analgesics in artificial abortion

作　　者：李增运[1] 张鸿飞[2] 杨立显[1] 史志远[1] 

机构地区：[1]兰州军区总医院安宁分院麻醉科,730070 [2]兰州大学第二临床医学院麻醉科,730030

出　　处：《实用疼痛学杂志》2008年第5期363-365,共3页Pain Clinic Journal

摘　　要：目的观察人工流产术应用丙泊酚靶控输注(TCI)复合不同药物静脉镇痛的临床效果和安全性。方法选择门诊自愿终止妊娠的女性120例(孕期<60 d)。随机分成P、F、L共3组,每组40例。鼻导管吸氧3 L·min^(-1),静脉注射东莨菪碱0.3 mg、格拉司琼3 mg,利多卡因0.4 mg·kg^(-1)。P组直接连接丙泊酚TCI泵,F组芬太尼0.1 mg加入丙泊酚中TCI,L组静脉注射氯诺昔康0.15 mg·kg^(-1)后丙泊酚TCI。以1%丙泊酚维持血药浓度为3～5μg·m1^(-1)开始静脉注射,逐渐增至5～7μg·ml^(-1),当睫毛反射消失时减至3～5μg·ml^(-1),术毕停药。术中监测受术者生命体征的变化、所需药量及副作用。术毕,由术者进行麻醉效果分级。结果P组与F组镇痛后3分钟,SpO_2、MBP、HR明显下降,与镇痛前比较差异有统计学意义(P<0.05);术中不自主性肢体活动P组显著多于F、L组(P<0.05);F组呼吸抑制发生率较P组高,但差异无统计学意义(P>0.05)。丙泊酚用量P组显著高于其他两组(P<0.01)。结论丙泊酚靶控输注复合氯诺昔康静脉镇痛在人工流产手术中较单一使用丙泊酚,具有丙泊酚用量小,麻醉效果好,呼吸、循环抑制轻之特点。Objective To compare the anesthetic effect and safety of propofol target controlled infussion（TCI） combined with analgesics in artificial abortion. Methods One hundred and twenty subjects scheduled for artificial abortion were randomly assigned into three groups with 40 cases in each group. Group P was given propofol TCI directly. In group F, fentanyl 0. 1mg was added into propofol 20 ml. In group L subjects were given TCI after given lornoxicam 0.15mg · kg^-1. At first 1 % propofol was given untill the blood concentration reached 5-7μg · ml^-1. When the eyelash reflex disappeared the blood concentration was decreased to 3-5μg · ml^-1 and infusion stopped at the end of the operation. Results In group P and F, the SpO2 ,MBP and HR decreased significantly at 3 minutes after induction compared with that before anesthesia. The dosage of propofol in group P was significantly more than that in the other two groups. Conclusion Propofol TCI combined with lornoxicam is a good and safe method for aritificial abortion with less side effects.

关 键 词：丙泊酚 氯诺昔康 靶控输注 全凭静脉麻醉 人工流产 

分 类 号：R614[医药卫生—麻醉学] R169.42[医药卫生—外科学]