依托咪酯复合咪达唑仑与芬太尼在人工流产术中的效果观察  

Clinical Observation of Etomidate Combined with Midazolam and Fentanyl for Artificial Abortion

作　　者：王海丽[1] 潘华[1] 屈海波[1] 陈进川[1] 

机构地区：[1]河南省三门峡市中心医院麻醉科,472000

出　　处：《临床合理用药杂志》2013年第27期54-56,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察依托咪酯复合咪达唑仑与芬太尼用于无痛人工流产术(人流)的临床效果及安全性。方法将80例早孕患者随机分为两组,依托咪酯组(E组)和丙泊酚组(P组)。E组5～10s内静脉缓注芬太尼咪达唑仑合剂(0.1ml/kg),接着静脉缓注依托咪酯;P组5～10s内静脉缓注芬太尼(0.1ml/kg),接着静脉缓注异丙酚(1ml/6s);记录麻醉开始诱导前(T0)、意识消失时(T1)、扩宫颈时(T2)及术毕苏醒时(T3)的平均动脉压(MAP)、脉搏血氧饱和度(SpO2)、心率(HR);意识消失时间、苏醒时间、行走恢复时间,丙泊酚用量及依托咪酯用量,不良反应发生情况。结果两组间各时点MAP、HR比较:在T1时点,E组高于P组;组内各时点MAP、HR比较:E组T1时点较T0低,P组T1时点较T0、T2、T3时点低。意识消失时间E组短于P组;低血压、心动过缓的发生率E组低于P组;肌阵挛的发生率E组高于P组。结论依托咪酯与咪达唑仑、芬太尼合理配伍,为无痛人流等短时诊疗性操作提供了较理想的静脉麻醉选择。Objective To investigate the analgesic effect and safety of etomidate combined with midazolam and fentanyl for artificial abortion.Methods Eighty patients who suffered from artificial abortion in our hospital were randomly divided into two groups： group E（40 patients） and group P（40 patients）.Group E was treated with etomidate combined midazolam and fentanyl,and group P was treated with propofol and fentanyl.The MAP,SPO2 and HR were recorded before induction of anesthesia（T0）,lost consciousness（T 1）,cervical dilatation（T2）,awaking from anesthesia（T3）.The time of lost consciousness and recovery,time to walk,the total dosage of propofol and etomidate,and adverse reaction were also recorded and analyzed.Results The MAP and HR at T 1 in group E were higher than group P.In group E,the MAP and HR at T 1 were lower than T 0.In group P,the MAP and HR at T 1 were lower than T 0,T 2,T 3.The time of lost consciousness in group E was shorter than group P.The incidence of hypotension and bracycardia in group E was lower than group P.The rate of myoclonus in group E was higher than group P.Conclusion The approach of etomidate combined with midazolam and fentanyl provides an ideal intravenous anesthetic choice for painless artificial abortion and other short time diagnosis and treatment operation.

关 键 词：依托咪酯 咪达唑仑 芬太尼 治疗结果 

分 类 号：R614[医药卫生—麻醉学]