舒芬太尼与芬太尼辅助丙泊酚在无痛人流手术中的应用观察  

Effect comparison of propofol combined with different dosage of fentanyl or sufentanyl on induced abortion

作　　者：陈燃[1] 

机构地区：[1]安徽医科大学第一附属医院麻醉科,安徽合肥230022

出　　处：《安徽医药》2010年第8期957-958,共2页Anhui Medical and Pharmaceutical Journal

摘　　要：目的比较不同剂量的芬太尼与舒芬太尼复合丙泊酚用于无痛性人工流产手术的观察。方法选择ASAⅠ-Ⅱ级,自愿施行无痛人流手术的孕妇120例,年龄20~35岁,体重45~60 kg,随机分为四组,每组各30例,分别应用芬太尼50、75μg、舒芬太尼5、7.5μg。各组丙泊酚以2 mg.kg-1、2 min匀速推注完毕,术中如有体动追加丙泊酚0.5 mg.kg-1。观察HR、BP、SPO2、术中体动情况及术毕清醒时间、术后宫缩痛状况。结果HR、BP、SPO2各组间比较无统计学差异。但各组内比较术前与术中、术毕HR、BP有显著变化（P〈0.05）,各组术中体动情况A组与B、C、D组比较,术中体动明显增多统计学差异有极显著性（P〈0.01）,术毕清醒时间无统计学差异（P〉0.05）。A组出现术后宫缩痛比C、D组明显增多（P〈0.05）,B组与D组比较差异亦有显著性（P〈0.05）,而D组与A组比较统计学差异有极显著性（P〈0.01）。结论舒芬太尼复合丙泊酚用于无痛人流优于芬太尼、丙泊酚组合。Aim To evaluate the efficacy and safety of fentanyl or sufentanil as supplement to propofol anaesthesia on induced abortion. Methods 120 early pregnancy women,ASA physical status Ⅰ - Ⅱ , age 20 - 35 yrs,weight 45 - 60 kg, undergoing induced abortion, were and randomly divided into feutanyl 50 μg group （group A, n = 30 ） , fentanyl 75 μg group （group B, n =30 ） , sufentanyl 5 μg group （group C, n = 30） and sufentanyl 7.5 μg group （group D, n = 30）. The intravenous anesthesia was employed with propofol in whole cases. Each dosage of feutanyl or sufentanyl was injected before propofol slowly administration 2 mg · kg^-1 in 2 minutes. According to the response of patient, additional propofol 0.5 mg· kg^-1 was injected during the procedure. The mean artery pressure （MAP） , heart rate （HR） ,pulse oxygen saturation （SpO2 ） , revival time, mobility of limb during procedures and pain of uterus contraction after operation were recorded. Results There were no significant difference of MAP, HR, SpO2, propofol dosage and revival time in both groups. However, MAP and HR during and immediately post-operation in each group was declined sharply than before procedure （ P 〈 0.05 ）. The incidence of limb movement in group A was higher than that in group B, C and D （P 〈 0. 001 ）. The uterus contraction pain in group A was more common than that in group C or D （ P 〈 0. 05, or P 〈 0.01 ） , as well as the statistical significances in group B compared in group D （ P 〈 0.05 ）. Conclusion Propofol combined with feutanyl or sufentanyl is safe and effective for induced abortion, but sufentanyl is superior to fentanyl in pain relief.

关 键 词：芬太尼 舒芬太尼 丙泊酚 人工流产 宫缩痛 

分 类 号：R614[医药卫生—麻醉学] R169.4[医药卫生—外科学]