摘要
目的观察诺扬(布托啡诺)对丙泊酚人工流产术麻醉深度和镇痛效应的影响。方法选择自愿接受人工流产择期手术的初孕患者100例(ASAI～II)随机均分为两组,每组各50例,F组(n=50):芬太尼复合丙泊酚组,麻醉诱导前5min先缓慢静脉注射芬太尼,5min后开始缓慢静脉注射丙泊酚至睫毛反射消失。B组(n=50):布托啡诺复合丙泊酚组,麻醉诱导前5min先缓慢静脉注射布托啡诺,5min后开始缓慢静脉注射丙泊酚至睫毛反射消失。记录手术前、诱导后、扩张子宫颈部时、刮宫时、手术结束时的血压、心率、脉搏氧饱和度、呼吸次数、脑电双频指数(BIS)、丙泊酚使用量、恢复时间、手术中体动的次数、手术后1h、2h可能存在的不良反应及患者下腹部疼痛程度。结果手术中血压、心率、脉搏氧饱和度和恢复时间基本相似(P>0.05)。丙泊酚使用量F组(160±28)mg多于B组(120±26)mg(P<0.05);手术前F组BIS值为(94±5),B组(95±4)。诱导后F组BIS为(35.4±10.2)、B组为(46.2±9.8),F组显著低于B组(P<0.05),手术中扩张子宫颈时F组BIS值(47.6±17.5)较B组数值(56.2±14.1)略低(P<0.05),B组体动要明显少于F组(P<0.05),手术后2h恶心、呕吐、头痛,头晕及患者下腹部疼痛程度两组间均无显著性差异(P>0.05)。结论布托啡诺复合丙泊酚用于门诊无痛人流麻醉比较芬太尼复合丙泊酚能更有利于调控麻醉深度,有效控制手术中体动反应,且减少丙泊酚用量。
Objective To investigate the effect ofbutorphanol on the depth of anesthesia and analgesia during artificial abortion with propofol anesthesia. Methods 100 patients （ASAI-Ⅱ） undergoing artificial abortion were randomly allocated into two groups. In group F （n = 50） the patients were given fentanyl 5min before propofol infusion, until eyelash reflex lost. In group B （n = 50）, 5min before propofol infusion, the patients were administrated 0.02 mg/kg butorphanol. The changes ofECG, SBP/DBP, HR, SpO2, the bispectrial index （BIS） and RR were monitored at the moment of consciousness, after Induction, dilating cervix, curettage of uterine and the end of operation. The dosage of pmpofol, extremities movement response （EMR） and the time that the patients regained consciousness and orientation were also recorded. In addition, the patient＇s chief complaint was observed and the stalin of pain was assessed by measuring VAS at lh and 2h after operation. Results Statistical analysis revealed no significant difference in general status： age, weight, gestation weeks, operation methods and the lime of operation （P〉0.05）. In addition, no differences were observed in SBP/DBP, HR, SpO2 and the time that the patients regained consciottsness and orientation （P〉0.05） between two groups. Group B notably reduced the consumption of propofol to （120±26） mg compared with group F （160±28） mg （P〈0.05）; The value of conscious BIS revealed no difference between group F and group B; after induction, the value of group F was（35.4±10.2）, while group B was （46.2±9.8）; at the moment of dilating cervix, the value of group F was （47.6±17.5） and group B was （56.2±14.1） （P〈0.05）. EMR was minimized in group B compared with group F （P〈0.05））At the lime 4h after operation, no significant differences were detected in the adverse effects in both groups. Conclusion Propofol combined with butorphanol （0.20mg/kg） for intravenous anesthesia during artificial abortion may be benefit for analgesia, control of the depth of anesthesia, reduction of the EMR and minimization of the consumption ofpropofol.
出处
《当代医学》
2009年第19期7-9,共3页
Contemporary Medicine
