瑞芬太尼与异丙酚靶控输注用于人工无痛流产术的临床观察  

Comparison of Different Plasma Effect-site Concentration of Propofol TCI with Remifentanl for Dilatation and Curettage

作　　者：马建英 康志秋 

机构地区：[1]山东省招远市人民医院麻醉科,山东招远265400

出　　处：《黑龙江医学》2011年第1期47-49,共3页Heilongjiang Medical Journal

摘　　要：目的比较人工流产术患者不同血浆靶浓度异丙酚联合一定剂量瑞芬太尼的麻醉效果。方法 80例早孕者随机分为4组,每组20例。Ⅰ组单纯用1%异丙酚,血浆靶浓度设定为7.5μg/mL,Ⅱ、Ⅲ、Ⅳ组输注异丙酚前1 min先静注0.3μg/kg瑞芬太尼,异丙酚血浆靶浓度分别设定为5.0μg/mL、5.5μg/mL、6.0μg/mL,待患者睫毛反射消失后开始吸宫操作。观察术前、睫毛反射消失时、吸宫时和手术结束时的MAP、SPO2、HR值,诱导时间、手术时间、唤醒时间和定向力恢复时间、患者体动及呼吸抑制发生率。结果与术前比,Ⅰ组睫毛反射消失时的MAP、HR显著降低(P<0.01),吸宫时MAP、HR均显著增高(P<0.05),Ⅱ、Ⅲ组睫毛反射消失时、吸宫时MAP、HR和术前比较显著降低(P<0.01),Ⅳ组各时间点MAP、HR较术前均显著下降(P<0.01),Ⅳ组呼吸抑制发生率明显增加(P<0.01),Ⅰ组诱导时间明显缩短(P<0.01),唤醒时间及定向力恢复时间明显延长(P<0.01),体动发生率Ⅰ、Ⅱ组明显增加(P<0.01)。结论 5.5μg/mL异丙酚血浆靶浓度复合0.3μg/kg瑞芬太尼行人工流产术麻醉效果确切,呼吸抑制发生率低,苏醒快,安全性高。Objective To compare the efficacy of different plasma effect-site concentrations of propofol TCI with Remifentanl for patients undergoing dilatation and curettage（DC）.Methods Eighty ASAⅠ～Ⅱ early pregnancy patients undergoing DC were randomly allocated into 4 groups based on the plasma effect-site propofol concentration by TCI（n=20）： group Ⅰ 7.5 μg/mL,Ⅱ 5.0 μg/mL,Ⅲ 5.5 μg/mL,and Ⅳ 6.0 μg/mL.Anestheaia was indued with propofol 7.5 μg/mL TCI in group Ⅰ and other three groups with Remifentanl 0.3 μg/kg and propofol TCI.Induced abortion was performed when eyelash reflex disappear.MAP,HR and SPO2 were continuously monitored and recorded before induction of anesthesia,after eyelash reflex disappeared,when and after operation.The duration of induction and maintenance of anethesia,wake and orientation recovery time,rates of respiratory depression,limb movement were also used to evaluate the efficacy of propofol TCI among the four groups.Results MAP and HR are more stable in group Ⅱ and Ⅲ,the frequency of limb movement was significantly higher in group Ⅰ and Ⅱ than in group Ⅲ and IV and the rate of respiratory depression is higher in group Ⅳ;wake and orientation recovery time longer in group Ⅰ.Conclusion Plasma effect-site propofol concentration 5.5 μg/mL with 0.3 μg/kg Remifentanl is safe and effective for patients undergoing dilatation and curettage（DC）.

关 键 词：靶控输注 无痛人流 瑞芬太尼 

分 类 号：R614[医药卫生—麻醉学]