不同剂量阿芬太尼与地佐辛在无痛人工流产手术中的麻醉效果  

Anesthetic Effect of Different Doses of Alfentanil and Dezocine in Painless Abortion Surgery

作　　者：黄涌[1] 石伯生[1] HUANG Yong;SHI Bosheng(Nantong City Traditional Chinese Medicine Hospital,Nantong 226001,China;不详)

机构地区：[1]南通市中医院,江苏南通226001

出　　处：《中外医学研究》2025年第4期61-64,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:评估不同剂量阿芬太尼与地佐辛在无痛人工流产手术中联合丙泊酚使用时的麻醉效果。方法:本研究前瞻性选取2023年2月—2024年2月在南通市中医院进行无痛人工流产手术的71例患者为研究对象,采用随机数表法将其分为对地佐辛组(接受地佐辛联合丙泊酚麻醉)、小剂量组(小剂量阿芬太尼联合丙泊酚麻醉)、大剂量组(大剂量阿芬太尼联合丙泊酚麻醉)。比较三组患者麻醉诱导前(T_(0))、给药前(T_(1))、扩宫颈前(T_(2))、扩宫颈后(T_(3))、苏醒时(T_(4))围手术期血流动力学[心率(HR)和平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)]、镇痛效果[术后3 h、12 h、24 h视觉模拟评分法(VAS)评分]、苏醒质量。结果:三组不同时间点HR、MAP、SBP、DBP比较,差异有统计学意义(P<0.05)。大剂量组诱导时间、苏醒时间、离院时间短于小剂量组及地佐辛组,差异有统计学意义(P<0.05)。术后3 h、12 h、24 h,大剂量组VAS评分低于小剂量组及地佐辛组,差异有统计学意义(P<0.05)。结论:使用阿芬太尼作为无痛人工流产手术麻醉的辅助药物,尤其是在较高剂量时,可以有效改善围手术期血流动力学稳定性,提供更优的术后镇痛效果,同时提高苏醒质量。因此,推荐在无痛人工流产手术中考虑使用适量阿芬太尼以优化麻醉管理。Objective:To evaluate the anesthetic effect of different doses of Alfentanil combined with Dezocine and Propofol in painless abortion surgeries.Method:This study prospectively selected 71 patients who underwent painless abortion in Nantong City Traditional Chinese Medicine Hospital from February 2023 to February 2024 as research objects.They were divided into Dezocine group(receiving Dezocine combined with Propofol),low-dose group(low-dose Afentanil combined with Propofol)and high-dose group(high-dose Afentanil combined with Propofol)by random number table method.The hemodynamics[heart rate(HR)and mean arterial pressure(MAP),systolic blood pressure(SBP),diastolic blood pressure(DBP)]before anesthesia induction(T_(0)),before administration(T_(1)),predilation(T_(2)),postdilation(T_(3)),after recovery(T_(4))and analgesic effects[visual analogue scale(VAS)score at 3 h,12 h,24 h after surgery],quality of recovery were compared among the three groups.Result:There were significant differences in HR,MAP,SBP and DBP among the three groups at different time points(P<0.05).The induction time,recovery time and discharge time in the high-dose group were shorter than those in the low-dose group and Dezocine group,and the differences were statistically significant(P<0.05).The VAS scores of 3 h,12 h and 24 h after surgery in the high-dose group were lower than in the low-dose group and Dezocine group,and the differences were statistically significant(P<0.05).Conclusion:Using Alfentanil as an adjunctive anesthetic in painless abortion surgeries,particularly at higher doses,can effectively improve perioperative hemodynamic stability,provide superior postoperative analgesic effects,and enhance recovery quality.Therefore,it is recommended to consider an appropriate dose of Alfentanil to optimize anesthetic management in painless abortion surgeries.

关 键 词：阿芬太尼 地佐辛 无痛人工流产 麻醉效果 血流动力学 视觉模拟评分 苏醒质量 

分 类 号：R61[医药卫生—外科学]