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目的观察单纯丙泊酚和复合芬太尼两种麻醉用法的临床效果,并进行比较,进一步验证丙泊酚复合芬太尼的配伍在人工流产术中的麻醉效果。方法选择在我院自愿要求行无痛人工流产手术的早孕妇女200例,随机分为复合芬太尼组(A组)和单纯丙泊酚(B组),二组一般情况相同。A组先芬太尼单次缓慢静推1.0μg/kg,0.5 min后再注入丙泊酚1.5 mg/kg,注药速度4 ml/10 s。B组单纯丙泊酚静脉推2.0 mg/kg,注药速度4 ml/10 s。两组均待患者意识消失(睫毛反射消失为标志)后开始手术,术中根据扩宫和宫内吸引、肢体活动情况,追加丙泊酚0.5 mg/kg。记录两组手术中平均动脉压、心率、呼吸、脉搏血氧饱和度、丙泊酚总用量、意识恢复时间、镇痛效果及严密监测不良反应。结果二组病人术中MAP、SPO2、R、HR均维持较稳定,差异无统计学意义(P>0.05)。两组镇痛效果对比,A组镇痛效果优于B组(P<0.01)。肢动发生率明显减少(P<0.01)。A组丙泊酚用量明显小于B组(P<0.01),两组术毕意识恢复时间差异无统计学意义(P>0.05)。结论丙泊酚复合芬太尼用于人工流产手术镇静、镇痛效果明显优于单纯使用丙泊酚。
Objective To observe the clinical effects of propofol and fentanyl anesthesia and to compare the anesthetic effects of propofol and fentanyl in artificial abortion. Methods A total of 200 pregnant women who volunteered to have painless abortion in our hospital were randomly divided into two groups: group A (fentanyl) and group B (propofol). The two groups were generally the same. Group A fentanyl was slowly and slowly push 1.0μg / kg, 0.5min after injection of propofol 1.5mg / kg, injection speed 4ml / 10s. B group intravenous propofol push 2.0 mg / kg, injection speed 4 ml / 10 s. Patients in both groups were to disappear consciousness (eyelashes disappear as a marker) after surgery, intraoperative expansion of intrauterine and intrauterine traction, limb activity, additional propofol 0.5 mg / kg. The mean arterial pressure, heart rate, respiration, pulse oximetry, total propofol consumption, conscious recovery time, analgesic effect and adverse reaction were recorded. Results The MAP, SPO2, R and HR in the two groups of patients remained relatively stable, with no significant difference (P> 0.05). The analgesic effect of the two groups was compared, the analgesic effect of group A was better than that of group B (P <0.01). The incidence of limb movement was significantly reduced (P <0.01). The dosage of propofol in group A was significantly lower than that in group B (P <0.01). There was no significant difference in recovery time between two groups (P> 0.05). Conclusion Propofol combined with fentanyl for artificial sedation sedation, analgesic effect was significantly better than the simple use of propofol.