【摘要】 目的比较异丙酚配伍芬太尼或曲马多应用于无痛人工流产术的效果。方法ASAⅠ-Ⅱ级人工流产术患者100例,随机分为5组(各20例),A组单纯静脉注射异丙酚2.5mg.kg-1;B组静脉注射芬太尼1μg.kg-1后静脉注射异丙酚2mg.kg-1;C组静脉注射芬太尼1.5μg.kg-1后静脉注射异丙酚1.5mg.kg-1;D组静脉注射曲马多1mg.kg-1后静脉注射异丙酚2mg.kg-1;E组静脉注射曲马多2mg.kg-1后静脉注射异丙酚2mg.kg-1。各组麻醉成功后均行人工流产术,监测各组术中血压(BP)、心率(HR)、脉搏血氧饱和度(SpO2)等生命体征,记录术中异丙酚使用剂量、麻醉时间(意识消失到呼之睁眼)、术毕唤醒时间、苏醒期有无躁动及术后有无下腹痛等。结果B组、C组分别与A组比较,SpO2<90%例数增加(P<0.05与P<0.01),异丙酚剂量减少(P<0.01),术后下腹痛减轻(P<0.01);C组与B组比较,SpO2<90%的例数差异无统计学意义(P>0.05),异丙酚剂量减少(P<0.01),术后下腹痛差异无统计学意义(P>0.05)。D组、E组分别与A组比较,SpO2<90%例数及异丙酚剂量都一样(P>0.05),术后下腹痛减轻(P<0.05)。麻醉时间及术毕唤醒时间,C组短于A组、B组(P<0.01);B-E组的苏醒期躁动较A组少(P<0.05)。结论无痛人工流产术中,异丙酚配伍芬太尼或曲马多都可增强术后镇痛、减少术毕躁动的发生率;且以异丙酚2mg.kg-1配伍芬太尼1μg.kg-1或曲马多1mg.kg-1为较佳选择。更多还原

【Abstract】 Objective To compare effects of propofol combined with fentanyl or tramadol used for artificial abortion painlessly.Methods One hundred ASA Ⅰ-Ⅱ artificial abortion patients were randomized into 5 groups(20 cases per group).They were administrated introveneously with frags.Group A was administrated with 2.5 mg·kg-1 of propofol only.Group B was with 1 μg·kg-1 of fentanyl and 2 mg·kg-1 of propofol.Group C was with of 1.5 μg·kg-1 fentanyl and 1.5 mg·kg-1 of propofol Group D was with 1mg·kg-1 of tramadol and 2.0 mg·kg-1 of propofol.Group E was with 2 mg·kg-1 of tramadol and 2 mg·kg-1 of propofol.Then artificial abortion was performed.Vital signs such as BP,HR and SpO2 were monitored.Propofol consumption,anaesthesia time,awaken time after operation,restlessness and post-operative hypogastric pain were recorded.Results Compared with Group A respectively,number of SpO2<90% in Groups B and C increased (P<0.05 and P<0.01),propofol consumption decreased (P<0.01) and post-operative hypogastric pain attenuated(P<0.01).Compared with Group B,Group C had same rate of SpO2<90%(P>0.05),decreased propofol consumption (P<0.01) and same post-operative hypogastric pain(P>0.05).Groups D and E had same number of SpO2 <90% and same propofol consumption with Group A (P>0.05).Compared with Group A,post-operative hypogastric pain in Group D and E reduced respectively(P<0.05).Anaesthesia time and awaken time in Group C were shorter than in Group A and B(P<0.01).Group B to E had less restlessness number than Group A(P<0.05).Conclusion When fentanyl or tramadol are used for artificial abortion,post-operative analgesia is enforced and rate of restlessness is decreased.Propofol 2 mg·kg-1 combined with fentanyl 1 μg·kg-1 or tramadol 1 mg·kg-1 show better selections.更多还原