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目的研究舒芬太尼复合丙泊酚用于无痛人工流产麻醉时两种药物的最佳配伍方案。方法选择人工流产患者180例,ASAⅠ-Ⅱ级,随机分为三组,每组60例,丙泊酚分别复合0.05、0.1、0.15μg/kg舒芬太尼进行人工流产麻醉,观察MAP、HR、SpO2,记录丙泊酚的总剂量、术中疼痛/镇痛效果、清醒时间、术中呼吸抑制、术后宫缩痛及术中知晓、梦幻、恶心呕吐等不良反应的发生率。结果 B组、C组的镇痛效果优于A组,差异有显著性(P<0.05),B组、C组镇痛效果Ⅰ级的患者比较无显著性差异(P>0.05)。与术前比较,A组MAP、HR稍有下降,但无显著性差异(P>0.05),SpO2明显下降(P<0.05);B组MAP无明显变化,HR和SpO2明显下降(P<0.05);C组MAP、HR明显下降(P<0.05)且SpO2下降更加明显(P<0.01)。A组丙泊酚总用量及意识恢复时间与B组和C组比较有显著性差异(P<0.05),B组和C组丙泊酚总用量及意识恢复时间比较无显著性差异(P>0.05)。A组术后宫缩痛发生率明显高于B组和C组(P<0.05),B组和C组比较无显著性差异(P>0.05)。而术中知晓、恶心、呕吐、梦幻等各组间比无显著性差异(P>0.05)。结论丙泊酚复合0.1μg/kg的舒芬太尼用于无痛人工流产麻醉,麻醉效果确切、安全、并发症少,值得临床推广。
Objective To study sufentanil combined with propofol for painless artificial abortion anesthesia best compatibility of the two drugs program. Methods 180 cases of induced abortion were randomly divided into three groups, 60 cases in each group and propofol 0.05,0.1,0.15μg / kg sufentanil for abortion anesthesia. MAP, HR , SpO2, the total dose of propofol was recorded, intraoperative pain / analgesic effect, awake time, intraoperative respiratory depression, postoperative contractions pain and intraoperative awareness, dream, nausea and vomiting and other adverse reactions. Results The analgesic effects of group B and group C were superior to those of group A (P <0.05). There was no significant difference between group B and group C (P> 0.05). Compared with preoperative, the MAP and HR in group A decreased slightly, but there was no significant difference (P> 0.05) and SpO2 decreased significantly (P <0.05). There was no significant change in MAP and HR and SpO2 in group B ); MAP and HR in group C decreased significantly (P <0.05) and SpO2 decreased more significantly (P <0.01). The total propofol dosage and recovery time in group A were significantly different from those in group B and group C (P <0.05). There was no significant difference in total propofol dosage and recovery time between group B and group C (P> 0.05). The incidence of postoperative uterine contractions in group A was significantly higher than those in groups B and C (P <0.05). There was no significant difference between group B and C (P> 0.05). The intraoperative awareness, nausea, vomiting, fantasy and other groups were no significant difference (P> 0.05). Conclusion Propofol 0.1μg / kg sufentanil for painless abortion anesthesia, the exact anesthesia, safety, fewer complications, worthy of clinical promotion.