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目的:旨在通过比较丙泊酚复合不同剂量的瑞芬太尼后的麻醉效果及其对呼吸、循环功能的影响及不良反应,探讨用于无痛人流术的合理配伍。方法:75例早孕者,均无麻醉前用药随机分三组,Ⅰ组单纯用1%的丙泊酚2mg/kg;Ⅱ组、Ⅲ组分别先静注瑞芬太尼0.3μg/kg、0.4μg/kg,注药时间不少于30秒,再输注丙泊酚1.5mg/kg,待患者睫毛反射消失后开始操作。观察术前、睫毛反射消失时、扩宫时、吸宫时、手术结束时的BP、Sp O2、HR、唤醒时间和定向力恢复时间,患者体动及术后宫缩痛情况。结果:和术前比,Ⅰ组,睫毛反射消失时、扩宫时的BP、HR显著降低。吸宫时,BP、HR显著增高,体动发生率和术后宫缩痛发生率明显增加。Ⅲ组各时间点BP、HR较术前均显著降低,呼吸抑制的发生率明显增加,唤醒时间及定向力恢复时间较Ⅰ组明显延长。结论:0.3μg/kg瑞芬太尼复合丙泊酚1.5mg/kg的麻醉效果确切,术后宫缩痛明显缓解,呼吸抑制发生率低,清醒程度高,在人工流产术中为一种安全有效的麻醉方法。
Objective: To compare the propofol with different doses of remifentanil after anesthesia and its effects on breathing, circulatory function and adverse reactions to explore the rational compatibility for painless abortion. Methods: 75 cases of early pregnancy were randomly divided into three groups without anesthesia, group Ⅰ was treated with propofol 2mg / kg 1%, group Ⅱ and Ⅲ were given intravenous remifentanil 0.3μg / kg, 0.4 μg / kg, injection time of not less than 30 seconds, then infusion of propofol 1.5mg / kg, until the patient lashes reflex began to operate. The time before surgery, the disappearance of eyelashes reflex, the expansion of the palace, the time of the abstinence, the end of surgery BP, Sp O2, HR, wake-up time and recovery time, body movement and postoperative contractions pain were observed. Results: Compared with the preoperative, group Ⅰ and eyelash reflex disappeared, BP and HR at dilation were significantly decreased. Abstinence Palace, BP, HR increased significantly, the incidence of body movement and postoperative uterine contractions increased significantly. The BP and HR of group Ⅲ were significantly lower than those before operation, the incidence of respiratory depression was significantly increased, and the recovery time of awakening and orientation was significantly longer than that of group Ⅰ. CONCLUSION: 0.3μg / kg remifentanil combined with propofol 1.5mg / kg has the best anesthetic effect, obviously relieved postoperative contractions pain, low respiration inhibition rate and high degree of awakening, which is a safe method in abortion Effective anesthetic method.