丙泊酚复合右美托咪定在无痛人工流产术中的应用  

Application of propofol combined with dexmedetomidine in pain-free artificial abortion

作　　者：孙晓群[1] 徐红娟[1] 王超[1] 朱瑾[1] 

机构地区：[1]扬中市人民医院麻醉科,江苏省212200

出　　处：《江苏医药》2014年第17期2050-2052,共3页Jiangsu Medical Journal

摘　　要：目的探讨丙泊酚复合右美托咪定用于无痛人工流产手术的效果。方法拟行无痛人工流产手术孕妇120例,随机均分为四组,采用丙泊酚麻醉。在静脉注射丙泊酚前10min,A组静脉注射芬太尼1μg/kg,B、C和D组分别静脉泵注右美托咪定0.2、0.6和0.8μg/kg。静脉注射丙泊酚至患者睫毛反射消失后开始手术,术中必要时每次追加丙泊酚0.5-1mg/kg。记录术前(T0)、输注右美托咪定结束后(T1)、睫毛反射消失后(T2)、术中(T3)、苏醒后(T4)的MAP、HR和SpO2;统计丙泊酚用量、手术时间和苏醒时间;评估苏醒后5、10、15min和30min时的宫缩痛NRS评分,记录躁动、呼吸抑制和恶心呕吐发生情况。结果四组麻醉效果均较满意。T1时,D组的MAP高于T0(P<0.05),四组HR均慢于T0(P<0.05)。四组T2时的MAP和HR均低于T0(P<0.05)。四组孕妇苏醒后NRS评分相仿(P>0.05)。C、D组术中躁动和呼吸抑制发生率均低于A、B组(P<0.05),丙泊酚用量也少于A、B组(P<0.05)。结论无痛人工流产手术中应用丙泊酚复合右美托咪定0.6μg/kg麻醉,具有术中麻醉平稳、显著减少丙泊酚用量,但不影响麻醉恢复的优点;其对术后宫缩痛与丙泊酚复合芬太尼麻醉相似。Objective To observe the outcomes of propofol combined with dexmedetomidine in pain-free artificial abortion.Methods A total of 120 pregnant women scheduled for artificial abortion under propofol anesthesia was randomly divided into 3groups.At 10 min before propofol anesthesia,fentany 1μg/kg was injected intravenously in group A and dexmedetomidine 0.2,0.6and 0.8μg/kg were injected in groups of B,C and D,respectively.Operation started at the time of loss of eyelash reflex after propofol injection,which was supplemented in a dose of 0.5-1mg/kg when agitation occurred intraoperatively.MAP,HR and SpO2 were recorded before operation（T0）,at the end of dexmedetomidine infusion（T1）,loss of eyelash reflex（T2）,during operation（T3）and awakening（T4）.The consumption of propofol,operation time and recovery time were counted.Utrine contractions pain score（NRS）was evaluated at 5,10,15 and 30min after awakening.The agitation,respiratory depression,nausea and vomiting were observed as well.Results Anesthesia was all satisfactory in 4groups.MAP in group D was higher at T1 than that at T0（P0.05）.HR was lower at T1 than that at T0 in 4groups（P0.05）.MAP and HR were lower at T2 than those at T0 in 4groups（P0.05）.NRS score of 4groups was similar（P0.05）.The incidences of agitation and respiratory depression were higher in groups of C and D than those in groups of A and B（P0.05）.The consumptions of propofol were less in groups of C and D than those in groups of A and B（P0.05）.Conclusion Anesthesia with propofol combined with dexmedetomidine 0.6μg/kg can provide a satisfactory efficacy in pain-free artificial abortion with reduced consumption of propofol,but without effect on the quality of recovery.The effect of anesthesia with propofol combined with dexmedetomidine 0.6μg/kg on NRS is similar to that of anesthesia with propofol combined with fentanyl.

关 键 词：右美托咪定 芬太尼 丙泊酚 人工流产 

分 类 号：R614[医药卫生—麻醉学]