长期酗酒对人工流产术异丙酚麻醉的影响  

The effects of chronic ethanol intake on induced abortion anesthesia with propofol

作　　者：汪芳俊[1] 万勇[1] 孙桂英[1] 蔡蓉[1] 

机构地区：[1]川北医学院附属医院麻醉科,四川省南充市637000

出　　处：《中国医药》2012年第3期351-353,共3页China Medicine

摘　　要：目的观察长期酗酒对人工流产术异丙酚麻醉的影响。方法选择行人工流产术妇女160例完全随机分为非酗酒组和酗酒组，各80例。术中根据患者对手术刺激的反应，必要时分次追加异丙酚0．5mg／kg。监测术前10min（T。）、人工流产术开始后1、3、5、10min（T2、T3、T4、T5）以及术后10min（T6）的平均动脉压、心率、呼吸频率、脉搏氧饱和度。记录2组患者异丙酚的诱导剂量以及术中追加剂量；观察人工流产综合征和术后恶心呕吐的发生情况；进行麻醉效果评价并记录患者苏醒时间和离院时间。结果手术开始后1min，2组患者平均动脉血压、心率和呼吸频率较术前有所降低（P〈0．05）；人工流产术开始后3min，2组患者平均动脉血压恢复到术前水平，而心率和呼吸频率在手术开始后10min恢复到术前水平。人工流产术开始后1—3min2组患者脉搏氧饱和度有轻微下降，但与术前比较，差异无统计学意义（P〉0．05）。2组患者麻醉效果差异无统计学意义（P〉0．05）。酗酒组患者异丙酚的诱导剂量和术中追加剂量均较非酗酒组患者均明显增加，差异有统计学意义[（150±46）“g比（1004-16）mg；（42±10）mg比（27±8）mg；P〈0．01]。非酗酒组苏醒时间与离院时间均较酗酒组延长，差异有统计学意义[（13±4）min比（8a-3）min；（26±7）min比（22±5）min；P〈0．05]。结论长期酗酒可以导致无痛人工流产手术麻醉时异丙酚的诱导剂量和术中追加剂量均明显增加；长期酗酒并不影响无痛人工流产时异丙酚的麻醉效果，异丙酚同样适合酗酒患者无痛人工流产手术麻醉。Objective To investigate the effects of chronic ethanol intake on propofol for induced abortion anesthesia. Methods One hundred and sixty induced abortion patients were divided into two groups（ n = 80 each） ： control patients and chronic alcoholic patients. A boluses of propofol 0. 5 mg/kg should be given every time to maintain anaesthesia during the operation. The mean blood pressure, heart rate, respiratory rate and pulse oxygen saturation were recorded 10 minutes before operation, 1 minute, 3 minutes, 5 minutes and 10 minutes from the beginning of operation and 10 minutes after operation. Both the amount of propofol required for anesthesia induction and anesthesia maintenance, the incidence of abortion syndrome, nausea and vomitting were recorded. The anesthetic quality and the time from iv injection of propofol till after the anaesthetic and patients could go home by themselves were observed and recorded. Results The mean blood pressure, heart rate and respiratory rate were decreased 1 minute from the beginning of operation. The mean blood pressure was recovered 3 minutes and both the heart rate and respiratory rate were recovered 10 minutes from the beginning of operation. There was not a significant difference both in the pulse oxygen saturation and the anesthetic quality between the two groups during operation. The amount of propofol required for anesthesia was markedly increased [ （ 150 ± 46） mg vs （ 100 ± 16 ） mg; （ 42 ± 10 ） mg vs （ 27 ± 8 ）mg;P 〈 0. 01 ] and the time patients came round or could go home themselves was shorter in chronic alcoholic patients[ （13 ±4）rain vs （8 ±3）rain; （26 ±7）rain vs （22±5）min;P 〈0. 051. Conclusions Chronic alcoholism induces a large doses of propofol required to induce and maintain anesthesia for induced abortion. It has no effect on the anaesthetic oualitv of DroDofol.

关 键 词：人工流产术 长期酗酒 异丙酚 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]