摘要
目的观察丙泊酚复合不同剂量舒芬太尼在无痛人流术麻醉中的临床效果及安全性。方法选择ASAⅠ或Ⅱ级拟在全身静脉麻醉下自愿行无痛人流术患者90例,随机分成3组:静注芬太尼1μg/kg(F组),舒芬太尼0.1μg/kg(SF1组),0.15μg/kg(SF2组),3组均缓慢静脉推注丙泊酚2.0mg/kg,密切观察至改良清醒镇静(MOAA/S)评分为0分时停止。记录注药前(T1)、睫毛反射消失时(T2)、手术开始时(T3)、手术开始后1min(T4)、术毕(T5)及清醒时(T6)的MAP、HR、SpO2。3组丙泊酚的总用量、起效时间、手术时间、意识恢复时间、清醒时间、术中体动发生情况,患者清醒后10min和30min的疼痛VAS的评分,记录恶心呕吐等不良反应发生的情况。结果 T2时SF2组SpO2组明显低于F和SF1组,T3时F组MAP、SpO2及HR均明显高于SF1和SF2组(P<0.05),但均在正常范围。SF2组丙泊酚的总用量明显少于F组与SF1组(P<0.05),SF1组起效时间、恢复意识时间、清醒时间均短于F组和SF2组(P<0.05),F组体动反应的例数明显高于SF1和SF2组(P<0.05),3组患者手术时间无显著差异(P>0.05)。结论丙泊酚复合0.1μg/kg舒芬太尼用于无痛人流手术,麻醉镇痛效果好,血流动力学稳定。
Objective To observe the clinical efficacy and safety of the different doses of sufentanil combined with propofol anesthesia for abortion.Methods Niney ASA I orⅡ patients scheduled for elective abortion under total intravenous anesthesia were randomly assigned into three groups with 30 cases each.Group F received fentanyl 1μg/kg intravenously i.v,group SF1 received sufentanil 0.1μg/kg i.v,and group SF2 received sufentanil 0.15μg/kg i.v.Three groups were given 2.0mg/kg of propofol until the responsiveness MOAA/S scale was zero.MAP,HR and SpO2 were recorded before injection of test drug（T1）,loss of the eyelash reflex（T2）,at the beginning of the operation（T3）,1min after the operation（T4）,at the end of the operation（T5）and awakening（T6）.The total usage of propofol,onset time,time duration of surgery,recovery time and awakening time along with side effects were determined.Postoperative abdominal pain intensity was assessed at 10 and 30min with VAS sale.Results Compared with group SF2,SpO2 increased at T2 in groups F and SF1（P〈0.05）.At T3,MAP and HR were higher in group F than those in groups SF1 and SF2（P〈0.05）.The total dose of propofol was less in the group SF2 compared with the other two groups（P〈0.05）.The onset time of propofol and recovery time and the time to awakening in group SF1 was shorter than those in groups F and SF2（P〈0.05）.Patients moving in response to surgical stimulation in the group F were far more than those in groups SF1 and SF2（P〈0.05）.The differences of operative time of patients in the three groups were not significant（P〈0.05）.Conclusion Propofol combined with 0.1μg/kg sufentanil could provide better analgesia and maintain hemodynamic stability in the artificial abortion operation.
出处
《滨州医学院学报》
2016年第4期272-274,共3页
Journal of Binzhou Medical University
