不同麻醉深度指数监测下瑞芬太尼与异丙酚复合麻醉对无痛人流术中疼痛和呼吸抑制影响  

Effects of remifentanil combined with propofol anesthesia on pain and respiratory depression during painless abortion under different anesthesia depth index monitoring

作　　者：李宗艳[1] 吴文双[1] 刘鑫[1] 孙福德[1] 严辉[1] LI Zongyan;WU Wenshuang;LIU Xin;SUN Fude;YAN Hui(Department of Anesthesiology,Dazhou Central Hospital,Dazhou 635000,Sichuan,China)

机构地区：[1]达州市中心医院麻醉科,四川达州635000

出　　处：《西部医学》2023年第9期1353-1356,1362,共5页Medical Journal of West China

基　　金：达州市卫生健康委员会科研课题(2019017)。

摘　　要：目的分析不同麻醉深度指数监测下瑞芬太尼、异丙酚复合麻醉对无痛人流术中疼痛和呼吸抑制影响。方法选取2020年1月—2021年6月在我院行无痛人流术的249例患者,采用简单随机分组法分为A、B、C 3组各83例,3组患者均采用瑞芬太尼、异丙酚复合麻醉,A组的麻醉深度控制为Narcotrend指数27~36,B组的麻醉深度控制为Narcotrend指数37~46,C组的麻醉深度控制为Narcotrend指数47~56,比较3组患者的麻醉效果、镇痛效果、呼吸抑制情况、麻醉复苏时间及不良反应发生率。结果A组的麻醉优良率为81.93%,B组的麻醉优良率为96.39%,C组的麻醉优良率为85.54%,B组的麻醉优良率明显高于A组和C组(P<0.05),A组和C组的麻醉优良率比较差异无统计学意义(P>0.05);A组和B组的镇痛总有效率比较差异无统计学意义(P>0.05),C组的镇痛总有效率明显低于A组和B组(P<0.05);A组的呼吸抑制总发生率明显高于B组和C组(P<0.05),B组和C组的呼吸抑制总发生率比较差异无统计学意义(P>0.05);A组的麻醉苏醒时间明显长于B组和C组(P<0.05),B组和C组的麻醉苏醒时间比较差异无统计学意义(P>0.05);B组的不良反应总发生率明显低于A组和C组(P<0.05),A组和C组的不良反应总发生率比较差异无统计学意义(P>0.05)。结论无痛人流术应用异丙酚复合瑞芬太尼麻醉的麻醉深度为Narcotrend指数37~46时可获得优秀的麻醉和镇痛效果,能有效减轻呼吸抑制,并且患者复苏时间较短,不良反应较少。Objective To analyze the effects of remifentanil combined with propofol anesthesia on pain and respiratory depression during painless abortion under different anesthesia depth index monitoring.Methods A total of 249 patients undergoing painless abortion in the hospital were enrolled from January 2020 to June 2021.According to simple random grouping method,they were divided into groups A,B and C,83 cases in each group.All the three groups were treated with remifentanil and propofol for anesthesia.The Narcotrend indexes in groups A,B and C were within 27-36,37-46 and 47-56,respectively.The anesthesia effect,analgesia effect,respiratory depression,anesthesia recovery time and incidence of adverse reactions were compared among the three groups.Results The good rates of anesthesia in groups A,B and C were 81.93%,96.39%and 85.54%,respectively.The good rate of anesthesia in group B was significantly higher than that in groups A and C(P<0.05),but there was no significant difference between group A and group C(P>0.05).There was no significant difference in total response rate of analgesia between group A and group B(P>0.05),which was significantly lower in group C than group A and group B(P<0.05).The total incidence of respiratory depression in group A was significantly higher than that in group B and group C(P<0.05),but the difference between group B and group C was not statistically significant(P>0.05).The recovery time of anesthesia in group A was significantly longer than that in groups B and C(P<0.05),but there was no significant difference between group B and group C(P>0.05).The total incidence of adverse reactions in group B was significantly lower than that in groups A and C(P<0.05),but there was no significant difference between group A and group C(P>0.05).Conclusion The anesthesia and analgesia effects of remifentanil combined with propofol anesthesia(Narcotrend indexes of 37-46)are significant during painless abortion,which can effectively alleviate respiratory depression,with short recovery time and few advers

关 键 词：异丙酚 瑞芬太尼 麻醉深度指数 疼痛 呼吸抑制 

分 类 号：R714.21[医药卫生—妇产科学]