摘要
目的比较丙泊酚血浆靶控输注分别复合芬太尼或舒芬太尼单次静脉注射及雷米芬太尼血浆靶控输注用于人工流产术的效果。方法选择120例行人工流产术的患者,随机分为芬太尼单次静脉注射组(F组)、雷米芬太尼血浆靶控输注组(R组,靶浓度为4ng/ml)和舒芬太尼单次静脉注射组(S组),分别复合丙泊酚血浆靶控输注(靶浓度为4μg/ml)行静脉全麻,观察起效时间、恢复时间、准确定向时间、术中体动(程度和次数)、镇痛效果、呼吸抑制、HR、MAP、SpO2变化及术后并发症等。结果R组麻醉起效时间显著低于F组和S组(P<0·01),麻醉恢复时间显著高于F组和S组(P<0·01),R组的丙泊酚总用量、吸宫时术中最低SpO2、术中体动及术后恶心呕吐、嗜睡均低于F组和S组(P<0·05,P<0·01),R组的呼吸抑制显著高于F组和S组(P<0·01)。结论丙泊酚血浆靶控输注复合雷米芬太尼血浆靶控输注的麻醉方法用于人工流产术,其镇痛效果优于丙泊酚血浆靶控输注复合芬太尼或舒芬太尼单次静脉注射的麻醉方法,但要注意雷米芬太尼呼吸抑制作用较强的特点。
Objective To compare the effect of propofol target-controlled infusion （TCI） combined with single fentanyl or sufentanyl injection and remifentanyl TCI in the artificial abortion. Methods One hundred and twenty ASA I patients aged 18-40 y, undergoing artificial abortion were randomly divided into three groups. The patients in group F received single fentanyl injection （1μg/kg）, in group R remifentanyl TCI （plasma concentration 4 ng/ml） ,and in group S single sufentanyl injection （0.1μg/kg）. All patients in the three groups were given propofol TCI （4μg/ml） at same time. The onset time, recovery time, correct orientation time, body movement during operation, verbal rating scale （VRS）, respiratory depression scale, HR, BP and SpO2 at different time points during operation, side effects after operation, total dosage of propofol, plasma and effectivesite propofol concentrations during anesthesia were recorded. Results The onset time was significantly shorter in group R than that in group F and S（P〈0.01）, but the recovery time in group R was longer than that in group F and S（P〈0. 01）. Total dose of propofol, the lowest SpO2 and body movement during operation, nausea and vomiting and sleepy after operation were significantly less in group R than those in group F and S（P〈0.01）. Respiratory suppression was greater in group R than that in group F and S（P〈0. 01）. Conclusion The analgesic effect of propofol TCI plus remifentanyl TCI used in artificial abortion is better than propofol TCI combined with fentanyl or sufentanyl intravenous injection with less side effects for the procedure with shorter duration. But attention should be paid to the respiratory depression of remifentanyl.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第6期411-413,共3页
Journal of Clinical Anesthesiology
关键词
靶控输注
丙泊酚
雷米芬太尼
舒芬太尼
Target-controlled infusion
Propofol
Remifentanyl
Sufentanyl
