摘要
目的用8种不同配方的全麻药物行人工流产,对其临床效果进行比较,为更加安全、有效的麻醉方法提供选择。方法160例ASAⅠ级18～37岁早孕妇女,分为8组,每组20例,I组:单纯丙泊酚静注;II组:芬太尼50μg静注+丙泊酚静注;III组:丙泊酚200mg+芬太尼100μg混合液静注;IV组眯唑安定2mg静注+芬太尼100μg静注;V组:丙泊酚200mg+氯胺酮50mg混合液静注;VI组:丙泊酚3mg/kg+瑞捷50μg混合液静注;VII组:丙泊酚2mg/kg+瑞捷100μg混合液静注;VIII组:丙泊酚1mg/kg+瑞捷150μg混合液静注。病人入室后开放静脉,监测BP、HR和SpO2,取上述分组中的一组药物静注,待病人睫毛反射消失开始手术,术中出现体动追加药物,手术操作过半停止用药。术中常规吸氧和辅助呼吸,术毕送入麻醉恢复室,清醒后无不适,自行离院。结果所有病人术中无记忆,BP变化不大,呼吸均有不同程度的抑制,HR<56bpm使用阿托品0.5mgiv有4例,分别为Ⅲ、Ⅳ、Ⅶ、Ⅷ组各1例,Ⅰ组的丙泊酚用量最多,体动率最高,Ⅷ组效果最好、体动率最小、清醒最快、离院时间最短,但呼吸暂停率为100%。结论人工流产不宜单纯使用镇静药,而应同时应用镇痛药才能达到无痛人流的目的。8组配方比较Ⅷ组疗效最好,但术中必须常规SpO2监测、面罩吸氧和辅助呼吸。凡全麻下人流均应备用急救药品和设备,以策安全。
Objectives To compare the clinical effects of eight different recipes of anesthetics on women undergoing artificial abortion, and to provide a safer and more effective anesthetic treatment for artificial abortion. Method One hundred and sity women with early pregnancy （ASA Ⅰ, 18-37 years old, ） were divided into eight groups of 20 women each. The patients in different groups received the following anesthetics treatment respectively： propofol only （group Ⅰ） ; propofol after 50μg （entanil iv （group Ⅱ）, 200mg propofol plus 100 μg fentanil （group Ⅲ）, 100 μg fentanil after 2mg dormicum （group Ⅳ） ; 200mg propofol plus 50mg ketamine （group Ⅴ ）, 3mg/kg propofol plus 50μg remifenranil （ group Ⅵ ）, 2mg/kg propofol plus 100μg remifenranil （group Ⅶ ）, and lmg/kg propofol plus 150μg remifentanil （groupⅧ）. The blood pressue（BP）, heart rate （HR）and SpO2 were monitored ,and anesthetics were given intravenously in all the patients. Surgery started after the patients lost their eyelash reflex. More anesthetits were added if body movement was observed during the surgery. Anesthetics stopped using after half of the surgery. Oxygen and artificial ventilation were routinely given during the surgery. After the surgery, patients were sent to the recovery room, felt no discomfort, and were discharged from hospital. Results During the surgery, all the patients had no memory, little changes in BP, and respiratory inhibition to some extent . Four patients,of whom,I was in group Ⅲ ,I in group Ⅳ ,I in group Ⅶ and I in group Ⅷ, were intravenously given 0.5mg atropine when their HR were less than 56 bpm. The patients in group Ⅰ were given the largest dose of proofol, and had highest rate of body movement. Treatments for group Ⅶ showed the best effect. The patients in group had lowest rate of body movement during the surgery, woke up quickly after the surgery, and stayed in hospital for the shortest time period. However, all the patients in group Ⅷ had apnea during the surgery. Conclusions To accomplish a pain-free artificial abortion, sedative must be used in combination with antalgics. The treatment with group Ⅶ anesthetics was the most effective, however, SpO2 monitoring, oxygenation with mask and artificial ventilation must be routinely performed during the surgery. For safety purpose, drugs and equipments for emergency treatments must be prepared for all the women udergoing artificial abortions under general anesthesia.
出处
《华南国防医学杂志》
CAS
2007年第1期12-14,共3页
Military Medical Journal of South China
关键词
无痛人流
全麻
瑞捷
丙泊酚
Pain-free artificial abortion
General anesthesia
Remifentanil
Propofol
