不同剂量环泊酚复合瑞芬太尼在无痛人流中的应用效果研究  

Application of different doses of cyclopofol combined with remifentanil in painless induced abortion

作　　者：张可 齐庆岭[1] 杨明玉 王绍磊 ZHANG Ke;QI Qing-ling;YANG Ming-yu(Department of Anesthesiology,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300100,China)

机构地区：[1]天津中医药大学第一附属医院麻醉科、国家中医针灸临床医学研究中心,天津300100

出　　处：《中国中西医结合外科杂志》2025年第2期263-266,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：北京康盟慈善基金会医学科研发展基金项目(S091)。

摘　　要：目的:观察不同剂量环泊酚复合瑞芬太尼在无痛人流手术中的应用效果。方法:选取择期行无痛人流手术的患者119例,用随机数字表法将患者分为三组:环泊酚0.3 mg/kg组(C1组,n=40)、环泊酚0.4 mg/kg组(C2组,n=40)、环泊酚0.5 mg/kg组(C3组,n=39)。C1组、C2组和C3组分别静脉注射瑞芬太尼1μg/kg和环泊酚0.3、0.4、0.5 mg/kg。手术过程如果患者出现体动,追加环泊酚0.1 mg/kg。10 min内追加次数≤1次,则为镇静成功。记录镇静成功例数、环泊酚追加例数、麻醉诱导时间、手术时间、苏醒时间。记录患者麻醉前(T0)、睫毛反射消失时(T1)、手术开始时(T2)、苏醒时(T3)的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))。记录术中出现体动例数、低氧血症、注射痛等不良反应情况。结果:与C1组比较,C2组、C3组镇静成功率明显升高,环泊酚追加比例明显降低(P<0.05)。三组的诱导时间未见明显差异(P>0.05)。与C1组比较,C2和C3组苏醒时间延长(P<0.05)。与T0时比较,T1、T2时三组的HR明显减慢、MAP明显降低,C3组的SpO_(2)明显降低(P<0.05)。与C3组比较,T1、T2时C1组、C2组的SpO_(2)明显升高(P<0.05)。与C1组比较,C2组、C3组的体动发生率明显降低(P<0.05)。与其他两组比较,C3组低氧血症发生率较高(P<0.05)。结论:无痛人流手术中应用环泊酚0.4 mg/kg剂量联合瑞芬太尼,更安全有效,苏醒快,不良反应发生率较低。Objective To observe the effect of different doses of cyclopofol combined with remifentanil in painless abortion.Methods 119 patients were selected for elective painless abortion.Patients were divided into 3 groups by random number table method:cyclopofol 0.3 mg/kg group(C1 group,n=40),cyclopofol 0.4 mg/kg group(C2 group,n=40),and cyclopofol 0.5 mg/kg group(C3 group,n=39).Groups C1,C2 and C3 were injected with remifentanil 1μg/kg and cyclopofol 0.3,0.4 and 0.5 mg/kg,respectively.If the patient has body movement during surgery,add 0.1 mg/kg of cyclopofol.If no more than one additional time is added within 10 minutes,sedation is successful.The successful rate of sedation,the number of additional cases of cyclopofol,anesthesia induction time,operation time and recovery time were recorded.Heart rate(HR),mean pressure(MAP),and blood oxygen saturation(SpO_(2))were recorded before anesthesia(T0),when eyelash reflex disappeared(T1),at the beginning of surgery(T2),and at recovery(T3).The incidence of adverse reactions such as body movement,hypoxemia and injection pain were recorded.Results Compared with C1 group,the success rate of sedation in C2 and C3 groups was significantly increased,and the proportion of drug supplementation was significantly decreased(P<0.05).There was no significant difference in induction time among the three groups.Compared with C1 group,the recovery time of C2 and C3 groups was longer(P<0.05).Compared with T0,HR and MAP in T1 and T2 groups decreased significantly,and SpO_(2) in C3 group decreased significantly(P<0.05).Compared with C3 group,SpO_(2) in C1 and C2 groups was significantly increased at T1 and T2(P<0.05).Compared with C1 group,the incidence of body movement in C2 and C3 groups was significantly decreased(P<0.05).Compared with the other two groups,the incidence of hypoxemia in C3 group was higher(P<0.05).Conclusion cyclopofol 0.4 mg/kg combined with remifentanil is safer and more effective,with faster recovery and less incidence of adverse reactions.

关 键 词：环泊酚 瑞芬太尼 无痛人流 镇静 

分 类 号：R614.2[医药卫生—麻醉学]