纳布啡联合丙泊酚用于无痛人工流产术麻醉的最适剂量选择  

Optimal Dosage of Nalbuphine Combined with Propofol for Painless Artificial Abortion

作　　者：肖兴鹏[1] 陈蕾[2] 王颖[1] 李思琪 马岚[1] 宋玲玲[1] Xiao Xingpeng;Chen Lei;Wang Ying;Li Siqi;Ma Lan;Song Linlin(Department of Anesthesia,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Gynecology,East Hospital of Renmin Hospital of Wuhan University)

机构地区：[1]武汉大学人民医院麻醉科,武汉430060 [2]武汉大学人民医院东院妇科

出　　处：《药物流行病学杂志》2019年第1期15-17,22,共4页Chinese Journal of Pharmacoepidemiology

基　　金：湖北省自然科学基金项目(编号:2014CFB733)

摘　　要：目的:探讨在无痛人工流产术中异泊酚复合纳布啡静脉麻醉时纳布啡的最适剂量。方法:自愿实施无痛人工流产术患者300例随机分成纳布啡Ⅰ组(N1组,纳布啡0. 10 mg·kg^(-1))、纳布啡Ⅱ组(N2组,纳布啡0. 15mg·kg^(-1))、纳布啡Ⅲ组(N3组,纳布啡0. 20 mg·kg^(-1))。各组患者分别静注相应剂量纳布啡,5 min后再缓慢注入丙泊酚,而后实施人工流产术。比较各组患者不同时点的收缩压(SBP)、心率(HR)、脉搏血氧饱和度(SpO2)变化,记录各组术中丙泊酚用量、手术时间、停药后苏醒时间、离院时间,以及术中辅助呼吸、术后恶心呕吐、离院时眩晕比例,苏醒5 min后腹痛VAS评分及麻醉效果。结果:3组患者麻醉后SBP均较前明显下降(P <0. 05),苏醒后SBP均恢复正常; HR及SpO_2则未见明显变化。3组患者各时点SBP、HR及SpO_2组间比较差异均无统计学意义(P>0. 05)。N2组、N3组患者术后中重度腹痛比例显著低于N1组(P <0. 05),麻醉效果优良率显著优于N1组(P <0. 05)。N1组患者术中丙泊酚用量与苏醒时间均明显高于N2组和N3组患者(P <0. 05); N1组、N2患者的离院时间、离院时眩晕者比例等明显低于N3组患者(P <0. 05)。结论:丙泊酚联合适宜剂量的纳布啡(0. 15 mg·kg^(-1))用于无痛人工流产术具有一定的安全性、有效性。Objective: To investigate the safety and the optimal dose of nalbuphine combined with propofol in painless artificial abortion. Methods: 300 cases of patients undergoing painless abortion were randomly divided into three groups,group N1( nalbuphine 0. 10 mg·kg^-1);group N2( nalbuphine 0. 15 mg·kg^-1);group N3( nalbuphine 0. 20 mg·kg^-1). Each group were given the corresponding dose nalbuphine,after 5 min,the propofol was injected slowly.Then abortion was performed. The systolic pressure( SBP),heart rate( HR),pulse oxygen saturation( SpO2) were recorded at different time points,and other data were recorded including the propofol dosage,operation time,recovery time,time of departure from the hospital,assisted respiration,nausea and vomiting,dizziness,the 5-minute VAS score after wake and anesthesia effect etc. Results: The SBP compared with pre-anesthesia in each group decreased significantly after anesthesia induction( P < 0. 05),but the SBP returned to normal when the patient awaked. There had no significant differences between the 3 groups about the SBP,HR and SpO2 at each time point( P > 0. 05). The rates of patients with moderate and severe abdominal pain in group N2 and group N3 were significantly lower than those in group N1( P < 0. 05),and the excellent anesthetic effect rate was also significantly superior to group N1( P < 0. 05). The propofol dosage and the recovery time of group N1 was superior to group N2 and group N3( P < 0. 05). The time of departure from the hospital and dizziness in group N1 and group N2 were significantly shorter or less than that in group N3( P < 0. 05). Conclusion: This study suggested that 0. 15 mg·kg^-1 nalbuphine combined with appropriate propofol was effective and safe for painless abortion.

关 键 词：无痛人工流产术 纳布啡 剂量 异泊酚 

分 类 号：R971.2[医药卫生—药品]