丙泊酚复合芬太尼在无痛人工流产中的应用效果  

Application effect of propofol combined with fentanyl in painless artificial abortion

作　　者：李信安[1] 唐文昌 曾宪荣[1] 张佳群 邹素姣 

机构地区：[1]深圳市宝安区石岩人民医院麻醉科,深圳518108 [2]深圳市罗湖区人民医院手术室,深圳518001

出　　处：《中国当代医药》2016年第8期135-137,共3页China Modern Medicine

摘　　要：目的研究丙泊酚复合芬太尼用于无痛人工流产麻醉时的最佳配伍方案。方法选取我院2014年5月～2015年8月收治的ASAⅠ～Ⅱ级行无痛人工流产患者200例，随机分为4组，每组50例。丙泊酚分别复合0．05（A组）、0．1（B组）、0．15μg／kg（C组）的芬太尼进行人工流产麻醉。D组单纯给予丙泊酚进行麻醉。观察MAP、HR、Sp02,记录丙泊酚追加剂量、术中镇痛效果、清醒时间、术后宫缩痛及术中知晓、梦幻、恶心、呕吐等不良反应的发生率。结果A、B、C组的镇痛效果优于D组，B、C组的镇痛效果优于A组（P〈0．05）。与术前比较，A、B组术中的MAP、HR、SpO2均稍有下降，但差异无统计学意义（P〉0．05），C组术中的MAP无明显变化（P〉0．05），HR、SpO2均明显下降（P〈0．05），D组术中的MAP、HR、SpO2均明显下降（P〈0．01）。4组术前的MAP、HR、SpO2比较差异无统计学意义（P〉0．05），A、B、C组与D组术中的MAP、HR、SpO2比较，差异有统计学意义（P〈0．05）。B、C组的丙泊酚追加剂量明显少于A组（P〈0．05），B、C组间差异无统计学意义（P〉0．05）；B、C组的清醒时间明显短于A组（P〈0．05），B、C组间差异无统计学意义（P〉0．05）。与D组比较，A、B、C组的丙泊酚追加剂量较少，清醒时间较短，差异无统计学意义（P〉0．05）。A、B、C组术后宫缩痛发生率与D组比较，差异有统计学意义（P〈0．05）。4组的并发症发生率差异无统计学意义（P〉0．05）。结论丙泊酚复合0．1μg／kg的芬太尼用于无痛人工流产的麻醉效果确切、安全、并发症少，值得临床推广。Objective To study the best combination scheme of propufol combined with fentanyl applied in anaesthesia of painless artificial abortion. Methods 200 patients with ASA grade Ⅰ - Ⅱ conducted painless artificial abortion and treated by our hospital from May 2014 to August 2015 were selected and they were randomly divided into four groups, and there were 50 cases in each group. Anaesthesia of painless artificial abortion was conducted with propofol combining with 0.05 μg/kg （group A）,0.1 μg/kg （group B）, 0.15 μg/kg （group C） of fentanyl,and group D was given simple propofol to conduct anaesthesia.MAP,HR and SpO2 was observed respectively,while additional dose of propofol, analgesic effect during operation,awake time,postoperative uterine contraction pain and incidence rate of adverse reaction such as intraoperative awareness,fantasy,nausea,vomiting and so on was recorded respectively. Results Analgesic effect of group A,B and C was better than that of group D （P〈0.05）,and analgesic effect of group B and C was better than that of group A （P〈0.05）.Compared with before operation,MAP,HR,SpO2 during operation in group A and B was decreased slightly,but there was no statistical difference （P〉0.05）,and MAP in group C had no obvious change during operation （P〉0.05）,HR,SpO2 was significantly decreased respectively （P〈0.05）;MAP,HR,SpO2 during operation in group D was significantly decreased （P〈0.01）.There was no statistical difference of MAP, HR,SpO2 before operation among 4 groups （P〉0.05）,and there was a statistical difference of MAP,HR,SpO2 during operation in group A,B and C compared with group D respectively （P〈0.05）.Additional dose of propofol in group B and C was significantly fewer than that of group A （P〈0.05）,and there was no statistical difference between group B and C （P〉0.05）;awake time in group B an C was significantly shorter than that in group A （P〈0.05）,and there was no statistical difference between group B and C （P〉0.0

关 键 词：丙泊酚 芬太尼 无痛人工流产 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]