异丙酚与芬太尼复合静脉麻醉用于人流术的临床评价

目的:评价异丙酚与芬太尼联合应用于人工流产的作用。方法:观察组140 例早孕(6 ～ 12 wk)妇女, 术前静脉内注射芬太尼0.05 ～ 0.1 mg (1.0 ～2.0 μg·kg^-1), 继以异丙酚2 mg·kg^-1 静脉内注射。术中静脉每次追加异丙酚0.5 mg·kg^-1 。观察麻醉效果、宫口松弛、手术时间、人流综合征的发生率及出血量, 并记录术前、术中、术后的血压、心率及血氧饱和度。同期140 例未采用任何镇痛方法行人工流产妇女为对照。结果:异丙酚与芬太尼联合应用在人工流产中镇痛效果确切, 有效率100 %, 宫口易于扩张, 缩短了手术时间(P <0.01) 。观察组中无1例发生人流综合征, 术前术后的血压、心率及血氧饱和度无异常变化。出血量与对照组无明显差异(P>0.05) 。结论:异丙酚与小剂量芬太尼联合应用在人工流产术中可减少手术时间和病人痛苦, 具有安全、有效、经济等优点, 值得临床推广应用。

Clinical evaluation of anaesthesia of propofol and fentanyl together used by intravenous administration in induced abortion

AIM: To observe the anaesthesia of propofol and fentanyl used together by intravenous administration in induced abortion.METHODS: 140 women in early pregnancy (6-12 weeks) were allocated into observed group, in which all the women were injected by fentanyl (0.05-0.1 mg or 1.0-2.0 μg·kg ^-1) intravenously before operation and then by propofol (2 mg·kg ^-1) intravenously to provide anesthesic effect; then they were injected by bolus of propofol (0.5 mg·kg ^-1).during the operation.Another group with early pregnant women without any anesthetic as controlled group.The following indices were observed and compared between two groups, including pain feeling, the dilatation degree of cervical os, operation time and the in cidence of induced abortion syndrome as well as the bleeding volume, blood pressure (BP), heart rate (HR) and the blood oxygen saturation (SpO₂) before, during and after the operation.RESULTS: The pain feeling of the observed group was much less than that of the controlled group (P <0.01);the dilatation degree of the cervical os of the observed group was greater than that of the controlled group (P <0.01), the operation time was apparently shorter than that of the controlled group, and the incidence of abortion syndrome of the propofol-fentanyl group was less than that of the controlled group (P < 0.01).There were no differences in BP,HR and SpO₂ in observed group before and after the operation.There were no diffenences in bleeding volume between two groups. CONCLUSION: Propofol and fentanyl used together during the induced abortion operation can not only decrease the pain feeling, shorten the operation time and reduce the incidence of abortion syndrome signficantly, but also is safe, effective and economical, which is worth being applied further in clinic.