论文部分内容阅读
目的观察不同剂量瑞芬太尼、异丙酚静脉全麻用于无痛人工流产术的麻醉效果及安全性,探讨最佳药物配伍组合。方法选择ASAⅠ~Ⅱ级妊娠6~9周、无全麻禁忌证、自愿接受无痛人工流产术的孕妇168例,随机分为R1、R2、R3组,每组56例。各组均先缓慢静脉注射瑞芬太尼(R1组0.5μg/kg、R2组1.0μg/kg、R3组1.5μg/kg)45 s,再缓慢静脉注射异丙酚(剂量:R1组2.0 mg/kg、R2组1.5 mg/kg、R3组1.0 mg/kg)至患者入睡并睫毛反射消失后手术开始,术中可酌情追加异丙酚0.5~1.0 mg/kg。观察记录注药前、睫毛反射消失时、扩宫吸宫时、手术结束时的MAP、HR、SpO2、RR变化及麻醉效果和各种不良反应。结果3组患者一般情况无明显差异;各组麻醉后睫毛反射消失时MAP、HR、SpO2、RR均有不同程度下降,尤以R3组最明显(与R1、R2组比P<0.05),其中R3组有3例一过性呼吸暂停,SpO2降至90%,经面罩加压吸氧后很快回升至95%以上;麻醉效果:R2、R3组明显优于R1组(P<0.05);异丙酚用量:R1组明显大于R2、R3组(P<0.05);术后宫缩痛:R2、R3组明显少于R1组(P<0.05)。结论瑞芬太尼1.0μg/kg复合异丙酚1.5 mg/kg静脉全麻用于无痛人工流产术具有麻醉效果好、镇痛作用强、不良反应小、安全性高的优点,是较为合理的药物配伍组合。
Objective To observe the anesthetic effects and safety of different doses of remifentanil and propofol intravenous anesthesia in painless artificial abortion and to explore the best combination of drugs. Methods Sixty-nine weeks of ASAⅠ ~ Ⅱpregnancy pregnancies were randomly divided into R1, R2 and R3 groups, 56 cases in each group. There were no contraindications to general anesthesia. 168 pregnant women who volunteered for painless induced abortion were randomly divided into two groups. Remifentanil (0.5μg / kg in R1 group, 1.0μg / kg in R2 group, 1.5μg / kg in R3 group) was given for 45 seconds after intravenous injection of intravenous propofol (dose: R1 group 2.0 mg / kg in group R2 1.5 mg / kg in group R2 1.0 mg / kg in group R3) until the patient fell asleep and the lashes reflex disappeared. Intraoperative discretion may be supplemented with propofol 0.5-1.0 mg / kg. Observed before injection, eyelash reflex disappeared, Palace expansion, MAP, HR, SpO2, RR changes at the end of surgery and anesthesia effects and various adverse reactions. Results There was no significant difference in the general condition among the three groups. MAP, HR, SpO2 and RR of eyelashes disappeared after anesthesia in all groups, especially in group R3 (P <0.05 vs R1 and R2) In group R3, 3 patients had a transient apnea, SpO2 decreased to 90%, and the pressure rose rapidly to over 95% after being pressurized by oxygen in the mask. The anesthetic effect was significantly better in group R2 and R3 than in group R1 (P <0.05). Propofol dosage: R1 group was significantly greater than R2, R3 group (P <0.05); postoperative contractions pain: R2, R3 group was significantly less than the R1 group (P <0.05). Conclusion Remifentanil 1.0μg / kg propofol 1.5mg / kg intravenous anesthesia for painless artificial abortion has the advantages of good anesthetic effect, strong analgesic effect, small adverse reactions, high safety, it is more reasonable The combination of drug compatibility.