羟考酮对异丙酚抑制人工流产术患者扩宫口反应效应室靶浓度的影响  

Effect of Oxycodone on Target Controlled Infusion of Propofol Inhibiting Dilatation Response in Women Undergoing Artificial Abortion

作　　者：谢文钦[1] 江惠琼[2] 高文峰[3] 陈如霜[1] 江长城[1] 谢文吉[1] 

机构地区：[1]福建医科大学附属泉州市第一医院麻醉科,泉州362000 [2]福建医科大学附属泉州市第一医院心功能室,泉州362000 [3]福建医科大学附属泉州市第一医院体检中心,泉州362000

出　　处：《福建医科大学学报》2014年第4期262-265,共4页Journal of Fujian Medical University

摘　　要：目的探讨不同剂量羟考酮对人工流产术患者异丙酚抑制扩宫口反应时效应室靶浓度的影响。方法选取100例自愿终止妊娠孕妇,随机分为4组:对照组(C组)和羟考酮Ⅰ组、Ⅱ组、Ⅲ组。4组均采用效应室靶控(TCI)输注始靶浓度为2.0μg/mL的异丙酚,达靶浓度后C组、Ⅰ组、Ⅱ组、Ⅲ组分别给予静脉注射羟考酮0、0.05、0.1、0.2mg/kg,3min后行人工流产术。依据患者有无体动反应按序贯法确定异丙酚靶浓度,相邻浓度梯度比为1.2。观察各组各时间段平均动脉压(MAP)、HR、SpO2,异丙酚半数有效效应室浓度(EC50),意识恢复时间、定向力恢复时间、异丙酚用量,术中、术后不良反应发生率,术后腹痛程度以及宫颈口松弛程度。结果异丙酚EC50随羟考酮剂量增加呈递减趋势(P<0.05);0.1及0.2mg/kg羟考酮组较其他2组的异丙酚用量下降、术后腹痛程度评分及止痛药使用率降低(P<0.05);各组意识恢复时间、定向力恢复时间、术后不良反应发生率之间差别无统计学意义,而0.2mg/kg羟考酮组较0.1mg/kg组术中不良反应增加(P<0.01);0.1及0.2mg/kg羟考酮组的宫颈口松弛程度较其他2组增加(P<0.05)。结论羟考酮联合异丙酚效应室靶控输注,可使异丙酚抑制扩宫口反应的EC50降低,镇静深度变浅。异丙酚效应室靶控输注复合羟考酮0.1mg/kg可使人工流产术扩宫过程中的呼吸、循环更稳定,不良反应减少。Objective To evaluate the effect of different dose of oxycodone on effective target effect-site concentration of propofol inhibiting dilatation response in women undergoing artificial abortion . Methods A total of 100 women with the intention of terminate pregnancy were randomLy divided into 4 groups（n=25 per group）：the control group ,the Ⅰ ,Ⅱ ,Ⅲ group injected with different concentration of oxycodone ,respectively . Using target controlled infusion （TCI） of propofol infusion ,the initial target concentration was 2 .0 μg/mL , and the intravenous concentration of oxycodone were 0 ,0 .05 , 0 .1 , 0 .2 μg/mL ,respectively . 3 minutes later underwent expanding uterus operation . The target concen-tration of propofol was determined by sequential method according to the body response ,and the adjacent concentration gradient was 1 .2 . Observed period mean arterial pressure（MAP） ,HR ,SpO2 ,median ef-fective effect-site concentration of propofol （EC50 ） ,the consciousness recovery time ,orientation recovery time ,propofol dosage ,postoperative adverse reactions ,the incidence of postoperative pain and the extent of cervical dilation in each group . Results Propofol EC50 showed a decreasing trend with increasing con-centrations of oxycodone（P〈0 .05） . The consciousness recovery time ,orientation recovery time ,post-operative serious adverse events were no difference between each group ,but there were more intraopera-tive adverse events in 0 .2 mg/kg group than in 0 .1 mg/kg group（P〈0 .01） . The propofol dosage ,post-operative pain severity score and painkillers usage were lower in 0 .1 mg/kg group and 0 .2 mg/kg group when compared with other two groups ,and the degree of cervix relaxation were higher than the later two groups . Conclusions Oxycodone combined with propofol by target-controlled infusion targeting effect-site can lower the propofol EC50 ,shallow depth of sedation . There were more stable respiratory and cir-culatory ,lower adverse events rate when combined with oxycodo

关 键 词：流产  人工 镇痛 羟可酮 二异丙酚 麻醉  静脉 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R719.7