摘要
目的:观察环泊酚联合瑞芬太尼用于无痛人工流产术麻醉的安全性、有效性及对心率变异性影响。方法:选取2021年10月-2023年12月本院自愿要求行无痛人工流产手术女性168例,根据使用不同静脉麻醉药分为对照组(n=85)与观察组(n=83),两组均采用1μg/kg瑞芬太尼镇痛,观察组诱导给予环泊酚注射液0.4mg/kg,对照组给予丙泊酚注射液1.6mg/kg,对比两组进入手术室(T0)、诱导后(T1)、手术开始(T2)、苏醒时(T3)的平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS),采集低频功率(LF)、高频功率(HF)、低频功率/高频功率(LF/HF)等心率变异性频域参数,记录镇静成功时间、睫毛反射消失时间,苏醒时间以及注射痛、低血压、心动过缓、体动、呛咳、呼吸抑制等不良反应发生情况。结果:两组下窥器时长及成功率无差异;观察组镇静成功时间(66.4±4.7 s)、睫毛反射消失时间(60.9±4.6 s)及苏醒时间(3.2±0.9 min)均长于对照组(51.8±4.5 s、46.7±4.2 s、2.6±0.8 min);心率变异性参数,两组T1、T2时LF、HF、LF/HF均低于T0时,对照组T2时LF、HF均低于T1,观察组T1、T2、T3时LF和HF,以及T1、T2时LF/HF均高于对照组;观察组体动、呛咳、呼吸抑制、注射痛等总发生率(8.4%)低于对照组(65.9%)(均P<0.05)。结论:环泊酚联合瑞芬太尼用于无痛人工流产术麻醉安全有效,可维持受术者血流动力学稳定和自主神经功能平衡,不良反应发生率更低。
Objective:To observe the influence of ciprofol combined with remifentanil for the painless abortion of women on their safety,effectiveness and heart rate variability.Methods:A total of 168 pregnant women who wanted painless abortion were selected and were divided into control group(n=85)and observation group(n=83)according to the use of different intravenous anesthetics.The women in both groups were given 1μg/kg remifentanil for analgesia,and the women in the observation group were induced anesthetics by ciprofol injection 0.4mg/kg and the women in the control group were induced anesthetics by propofol injection 1.6mg/kg.The values of the mean arterial pressure(MAP),heart rate(HR),and bispectral index(BIS)of the women before entering the operating room(T0),after induction(T1),at the beginning of surgery(T2),and at the time of awakening(T3)were compared between the two groups.The values of the frequency domain parameters of the heart rate variability,such as low-frequency power(LF),high-frequency power(HF)and low-frequency power/high-frequency power(LF/HF)of the women in the two groups were collected.The successful sedation time,the disappearance of eyelash reflex time,the awakening time,and the occurrence of adverse reactions,such as injection pain,hypotension,bradycardia,body movement,coughing and respiratory depression,of the women in the two groups were recorded.Results:There were no significant differences in the duration and success rate of the speculum inserted of the women between the two groups.The successful sedation time(66.4±4.7s),the eyelash reflex disappearance time(60.9±4.6s)and the recovery time(3.2±0.9min)of the women in the observation group were significantly longer than those(51.8±4.5s,46.7±4.2sand 2.6±0.8min)of the women in the control group.As for the frequency domain parameters of the heart rate variability,the LF,HF and LF/HF values of the women in the two groups at T1and at T2 were significantly lower than those of the women at T1.The LF and HF values of the women in the observation group at T1and at T2were significantly lower than those of the women at T1.The LF and HF values of the women at T1,T2and T3,and the LF/HF value of the women at T1and T2in the observation group were significantly higher than those of the women in the control group.The total incidence of the body movement,bucking,respiratory depression and injection pain(8.4%)of the women in the observation group was significantly lower than that(65.9%)of the women in the control group(all P<0.05).Conclusion:Ciprofol combined with remifentanil for is safe and effective for anesthesia during painless abortion of the women,and which can maintain the hemodynamic stability and autonomic nerve function balance of the women,and with lower incidence of the adverse reactions.
作者
齐庆岭
李莹
刘芳
梁学梅
张雅静
韩雪
潘阳阳
QI Qingling;LI Ying;LIU Fang;LIANG Xuemei;ZHANG Yajing;HAN Xue;PAN Yangyang(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center of Acupuncture and Moribustion,Tianjin,300381)
出处
《中国计划生育学杂志》
2025年第4期775-780,共6页
Chinese Journal of Family Planning
基金
北京康盟慈善基金会医学科学发展基金项目(S091)。
