异丙酚配伍芬太尼或曲马多用于无痛人工流产术的效果比较  

Comparison of Propofol Combined with Fentanyl or Tramadol Used for Artificial Abortion Painlessly

作　　者：张华丹[1] 王立昌[1] 张英[1] 魏薇[1] 

机构地区：[1]北京大学深圳医院麻醉科,广东深圳518036

出　　处：《南昌大学学报（医学版）》2010年第1期71-74,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的比较异丙酚配伍芬太尼或曲马多应用于无痛人工流产术的效果。方法ASAⅠ-Ⅱ级人工流产术患者100例,随机分为5组(各20例),A组单纯静脉注射异丙酚2.5mg.kg-1;B组静脉注射芬太尼1μg.kg-1后静脉注射异丙酚2mg.kg-1;C组静脉注射芬太尼1.5μg.kg-1后静脉注射异丙酚1.5mg.kg-1;D组静脉注射曲马多1mg.kg-1后静脉注射异丙酚2mg.kg-1;E组静脉注射曲马多2mg.kg-1后静脉注射异丙酚2mg.kg-1。各组麻醉成功后均行人工流产术,监测各组术中血压(BP)、心率(HR)、脉搏血氧饱和度(SpO2)等生命体征,记录术中异丙酚使用剂量、麻醉时间(意识消失到呼之睁眼)、术毕唤醒时间、苏醒期有无躁动及术后有无下腹痛等。结果B组、C组分别与A组比较,SpO2<90%例数增加(P<0.05与P<0.01),异丙酚剂量减少(P<0.01),术后下腹痛减轻(P<0.01);C组与B组比较,SpO2<90%的例数差异无统计学意义(P>0.05),异丙酚剂量减少(P<0.01),术后下腹痛差异无统计学意义(P>0.05)。D组、E组分别与A组比较,SpO2<90%例数及异丙酚剂量都一样(P>0.05),术后下腹痛减轻(P<0.05)。麻醉时间及术毕唤醒时间,C组短于A组、B组(P<0.01);B-E组的苏醒期躁动较A组少(P<0.05)。结论无痛人工流产术中,异丙酚配伍芬太尼或曲马多都可增强术后镇痛、减少术毕躁动的发生率;且以异丙酚2mg.kg-1配伍芬太尼1μg.kg-1或曲马多1mg.kg-1为较佳选择。Objective To compare effects of propofol combined with fentanyl or tramadol used for artificial abortion painlessly. Methods One hundred ASA I -- II artificial abortion patients were randomized into 5 groups（20 cases per group）. They were administrated introveneously with frags. Group A was administrated with 2. 5 mg . kg-1 of propofol only. Group B was with 1 ug . kg-1 of fentanyl and 2 mg . kg-1 of propofol. Group C was with of 1.5 ug . kg-1 fentanyl and 1.5 mg. kg-1 of propofol Group D was with ling . kg-1 of tramadol and 2.0 mg . kg-1 of propofol. Group E was with 2 mg . kg-1 of tramadol and 2 mg . kg-1 of propofol. Then artificial abortion was performed. Vital signs such as BP, HR and SpO2 were monitored. Propofol consumption, anaesthesia time, awaken time after operation, restlessness and post-operative hypogastric pain were recorded. Results Compared with Group A respectively,number of SpO2〈90% in Groups B and C increased （P〈0.05 and P〈0.01）,propofol consumption decreased （P〈0.01） and post-operative hypogastric pain a ttenuated（P〈0.01）. Compared with Group B,Group C had same rate of SpO2〈90%（P〉0.05） ,decreased propofol consumption （P〈0.01） and same post-operative hypogastric pain（P〉0.05）. Groups D and E had same number of SpO2〈90% and same propofol consumption with Group A （P〉0.05）. Compared with Group A,post-operative hypogastric pain in Group D and E reduced respectively（P〈0.05）. Anaesthesia time and awaken time in Group C were shorter than in Group A and B（P〈0.01）. Group B to E had less restlessness number than Group A（P〈0.05）. Conclusion When fentanyl or tramadol are used for artificial abortion, post-operative analgesia is enforced and rate of restlessness is decreased. Propofol 2 mg . kg-1 combined with fentanyl 1 ug . kg-1 or tramadol 1 mg . kg-1 show better selections.

关 键 词：人工流产术 异丙酚 芬太尼 曲马多 

分 类 号：R971.2[医药卫生—药品]