监测下麻醉管理技术与静脉全麻在门诊人工流产手术中的比较  

Effect comparison of monitored anesthesia care management technology and intravenous anesthesia inoutpatient artificial abortion operation

作　　者：金学勇[1] 金娜[1] 祁燕[1] 侯倩丽 

机构地区：[1]新疆生产建设兵团农二师库尔勒医院麻醉科,841000

出　　处：《中国综合临床》2014年第1期93-95,共3页Clinical Medicine of China

摘　　要：目的对瑞芬太尼辅助宫旁阻滞监测下麻醉管理技术在门诊无痛人工流产手术中的应用效果。方法选择要求无痛人工流产手术的患者80例，ASAI、II级，随机分为异丙酚静脉全身麻醉组（E组，40例）和瑞芬太尼辅助宫旁阻滞监测下麻醉管理技术组（R组，40例）。观察患者麻醉用药前、中、后的心率、呼吸频率、平均动脉压（MAP）、血氧饱和度（SpO2）的变化情况。记录两组患者手术时间、呼吸抑制时间、苏醒时间、VAS镇痛评分、离院时间及患者满意度。结果与用药前比较，两组患者用药后MAP、心率、呼吸频率、Sp02均明显降低（P〈0．05或P〈0．01）；麻醉中呼吸频率、Sp02R组低于E组（P均〈0．05）；E组注射疼痛、肢体运动的发生例数多于R组（注射疼痛：11例与0例，P=0．0004；肢体肢体运动：4例与0例，P=0．0402）；清醒时间、离院时间E组明显长于R组[清醒时间：（5．01±0．75）min与（0．00±0．0）min，t=-42．248，P：0．000；离院时间：（27．78±4．65）min与（18．68±3．80）min，t=-9．584，P=0．000]；VAS评分E组优于R组[（0．00±0．0）分与（0．45±0．09）分，t=3．162，P=0．002]；两组患者满意度均达100％。结论在门诊人工流产手术麻醉中，异丙酚静脉全身麻醉与瑞芬太尼辅助宫旁阻滞监测下麻醉管理技术比较，监测下麻醉管理技术镇痛确切、血流动力学平稳、术后恢复快、不良反应少并缩短了离院时间，其效果优于异丙酚静脉全身麻醉，是一种安全有效的麻醉方法。Objective To investigate the analgesia effects and ad^rse effect of the monitored anesthesia care of remifentanil assisted by cervix nerves block and the propofol intravenous general anesthesia on abortion. Methods Eighty patients with ASA I-II were selected and divided into the group of propofol intravenous general anesthesia （E group,n =40） and the group of the monitored anesthesia care of remifentanil assisted by cervix nerves block （ R group, n = 40 ）. Heart rate （ HR ）, respiratory rate （ RR ）, mean arterial pressure（MAP） , oxygen saturation（ SpO2 ） were recorded before, during and after the operation. Operative time, respiratory depression time, recovery time, VAS score, hospital time and patient satisfaction of the patients in the two groups were recorded. Results The MAP, HR, RR, SpO2 of the patients in the two groups after analgesia were significantly decreased compared with that of before analgesia （ P 〈 0. 05 or P 〈 0.01 ）. The levels of RR, SpO2 in R group after analgesia were obviously lower than that in group E （ P 〈 0. 05 ）. The cases number who occurred incidence of injection pain, physical movement in E group were higher than that in R group （injection pain ： 11 cases vs. 0 case, P = 0. 0004 ; Physical movement ： 4 cases vs. 0 case, P = 0. 0402 ）. The wake up time and the period of staying in hospital in E group were longer than that of R group（wake up time： （5.01 ＋0. 75） min vs. （0. 00 ± 0. 00 ） rain, t = - 42. 248, P = 0. 000 ; Time from hospital ： （ 27.78± 4. 65 ） min vs. （ 18. 68 ±3.80） min,t = -9. 584,P =0. 000）. The analgesic effects of VAS in E group was （0. 00 ±0. 0） ,better than that of group R （ （ 0.45 ± 0.09 ）, t = 3. 162, P = 0. 002 ）. The satisfaction rate in two groups were 100%. Conclusion The method of monitored anesthesia care of remifentanil assisted by cervix nerves block is proved to be better than that of propofol intravenous general anesthesia at induced abortion regarding of precise mon

关 键 词：瑞芬太尼 异丙酚 人工流产 静脉全身麻醉 监测下麻醉管理技术 

分 类 号：R614[医药卫生—麻醉学]