【摘要】 目的比较瑞芬太尼与曲马多伍用异丙酚静脉麻醉用于无痛人流术的临床效果。方法选择门诊ASAⅠ~Ⅱ早孕行人流自愿参加本实验的患者90例,随机分为瑞芬太尼(A组)、曲马多组(B组)和单用异丙酚组(C组),每组各30例。A组瑞芬太尼1.0μg/kg持续静注60 s,随后静注异丙酚2 mg/kg,B组曲马多1 mg/kg-1+异丙酚2 mg/kg,C组静注2 mg/kg诱导,术中维持每次追加异丙酚0.5~1.0 mg/kg。观察麻醉前后MAP、HR、SpO2的变化,注射痛和术后宫缩痛的发生情况,记录异丙酚总用量、手术时间、术毕呼之睁眼时间、离院时间及不良反应。结果三组患者诱导后MAP、HR、SpO2均有所下降,但下降幅度均在正常范围内。A、B两组注射痛和术后宫缩痛的发生率明显低于C组(P<0.01),异丙酚总用药量明显少于C组(P<0.01),B组呼吸抑制发生率明显低于A、C两组(P<0.01)。结论瑞芬太尼与曲马多伍用异丙酚静脉麻醉用于人工流产术较单用大剂量异丙酚具有麻醉效果好,能显著减少异丙酚用量。更多还原

【Abstract】 Objective To compare the clinical effect of remifentanil or tramadol with propofol anesthesia for painless induced abortion.Methods 90 ASAⅠ～Ⅱ women with early pregnant were randomly divided into three groups:group A,group B,group C.Each group had 30 patients.In group A anesthesia was induced with remifentanil 1.0μg/kg and propofol 2mg/kg,in group B anesthesia was induced with tramadol 1mg/kg and propofol 2mg/kg,whereas in group C anesthesia was induced with propofol 2mg/kg.Anesthesia of all patients were maintained with propofol 0.5～1.0mg/kg.The following were recorded and compared in three groups:（1）The changes in MAP,HR and SpO₂ during anesthesia;（2）Fell of pains for intravenous injection and postoperative pains of uterine contraction;（3）The time of eye opening at request after end of anesthesia;（4）The total doses of propofol;（5）The side-effects after operation.Results After induction,MAP,HR and SpO₂ decreased in the three groups.The incidence of pains of intravenous injection and postoperative pains of uterine contraction were significantly lower in group A and group B than those in group C（P<0.01）.The total doses of propofol was less in group A and group B than that in group C（P<0.01）.The incidence of respiratory suppression was significantly lower in group B than that in group A and group C（P<0.01）.Conclusion Remifentanil or tramadol with propofol anesthesia has better effect than large of doses propofol singly used for painless induced abortion,and decrease propofol doses,and decrease the pain intensity of intravenous injection and postoperative pains of uterine contraction.更多还原