异丙酚-依托咪酯脂肪乳混合液联合舒芬太尼在无痛人工流产麻醉中的效果研究  

Study on anesthetic effect of propofolum- etomidate fat emulsion combined with sufentanil in painless artificial abortion

作　　者：邹学军[1] 简道林[1] 

机构地区：[1]三峡大学仁和医院麻醉科,湖北宜昌443001

出　　处：《中国妇幼保健》2014年第30期4954-4956,共3页Maternal and Child Health Care of China

基　　金：湖北省教育厅科研项目〔B2013170〕

摘　　要：目的:探讨异丙酚-依托咪酯脂肪乳剂混合液联合舒芬太尼在门诊无痛人工流产麻醉中的效果,为人工流产麻醉药物的筛选提供理论依据。方法:选取在该院行人工流产术的孕妇60例,随机分为异丙酚-依托咪酯脂肪乳剂混合组(A组)和异丙酚-依托咪酯脂肪乳剂混合液+舒芬太尼组(B组),每组各30例。混合液配方均为1.0%异丙酚注射液20 ml+0.2%依托咪酯脂肪乳10 ml。B组在用药前先单次缓慢注射舒芬太尼5μg,然后两组孕妇均以200 ml/h的速度持续泵注异丙酚-依托咪酯脂肪乳剂混合液,直至孕妇的脑电双频指数(BIS)值降至45,随即停止泵药并开始手术。记录两组孕妇注药前和注药后1、2、3、5、10 min的收缩压(SBP)、舒张压(DBP)和心率(HR)水平;比较两组孕妇注射痛和肌阵挛的发生率;观察两组孕妇的苏醒情况并比较术后子宫收缩痛、恶心和呕吐等并发症的发生率。结果:两组孕妇在泵注混合液后组内、组间血压比较,差异无统计学意义(P>0.05)。B组注药所引起的注射痛发生率(13.3%)、肌阵挛发生率(6.7%)和子宫收缩痛发生率(20.0%)均显著低于A组(40.0%、20.0%和80.0%),两组比较,差异有统计学意义(P<0.05)。两组苏醒时间、苏醒质量、恶心和呕吐等并发症的发生率比较,差异无统计学意义(P>0.05)。结论:异丙酚-依托咪酯脂肪乳混合液用于无痛流产麻醉,孕妇血流动力学稳定。配伍应用5μg舒芬太尼,注射痛与肌阵挛发生率低,不影响苏醒时间且苏醒期子宫收缩痛发生率低,值得在临床中推广应用。Objective： To explore the anesthetic effect of propofolum - etomidate fat emulsion combined with sufentanil in painless artificial abortion, provide a theoretical basis for screening anesthetics for artificial abortion. Methods： Sixty pregnant women undergoing artificial abortion in the hospital were selected and randomly divided into group A （propofolum -etomidate fat emulsion） and group B （propofolum - etomidate fat emulsion combined with sufentanil）, 30 pregnant women in each group. The mixture was composed of 1.0% propofolum injection （20 ml） and 0. 2% etomidate fat emulsion （10 ml） . Before medication, the pregnant women in group B were treated with single slow injection of sufentanil （5 μg）, then the pregnant women in the two groups were treated with propofolum - etomidate fat emulsion at a constant rate of 200 ml/h until the values of bispectral index （BIS） decreased to 45 in the two groups, then surgery was conducted. The levels of systolic blood pressure （SBP） and diastolic blood pressure （ DBP）, heart rates before drug injection and at 1,2, 3, 5 and 10 minutes after drug injection in the two groups were recorded; the incidence rates of injection pain and myoclonus in the two groups were compared ; the situations of anesthesia recovery in the two groups were observed ; the incidence rates of uterine contraction pain, nausea and vomiting after surgery in the two groups were compared. Results： There was no statistically significant difference in blood pressure between the two groups （P 〉 0. 05） . The incidence rates of injection pain, myoclonus and uterine contraction pain in group B were 13.3 %, 6.7% and 20. 0%, respectively, which were statistically significantly lower than those in group A （40. 0% , 20. 0% and 80. 0% ） （P 〈 0. 05 ） . There was no statistically significant difference in the time and quality of anesthesia recovery, the incidence rates of nausea and vomiting between the two groups （P 〉 0. 05 ） . Conclusion： Haemodynamics of pre

关 键 词：异丙酚 依托咪酯脂肪乳 舒芬太尼 子宫收缩痛 

分 类 号：R714.21[医药卫生—妇产科学]