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目的观察异丙酚联合芬太尼、盐酸利多卡因用于无痛人工流产的临床效果。方法 100例人工流产手术患者先注射盐酸利多卡因5～10 mg(2%盐酸利多卡因1 ml加生理盐水20 ml稀释后静脉推注5～10 ml),再用生理盐水冲血管后静脉推注芬太尼50μg,再接受异丙酚静脉麻醉,诱导剂量为1.5 mg/kg,术中必要时分次追加20～40 mg,以维持适当麻醉浓度,术中分别于宫颈顺时针方向3点、9点处注射盐酸利多卡因40 mg(2%盐酸利多卡因2 ml加生理盐水4 ml),用无菌棉签,蘸2%盐酸利多卡因约0.6 ml(含盐酸利多卡因12 mg)插入宫颈管达宫颈内口处,1 min后取出。结果镇痛效果确切,加用盐酸利多卡因可以减轻异丙酚对血管的刺激作用,加用芬太尼可提高患者痛阈,宫颈封闭盐酸利多卡因,宫口松弛,手术时间短,减少了异丙酚的用量,降低了手术成本,减轻了患者的经济负担。结论无痛人工流产时三药联合能提供平稳的麻醉效果。
Objective To observe the clinical effect of propofol combined with fentanyl and lidocaine for painless induced abortion. Methods 100 cases of induced abortion were injected with lidocaine hydrochloride 5 ~ 10 mg (2% lidocaine hydrochloride 1 ml plus normal saline 20 ml intravenously 5 ~ 10 ml), and then saline The bolus of fentanyl 50μg, and then received propofol intravenous anesthesia, the induction dose of 1.5 mg / kg, intraoperative additional 20 ~ 40 mg when necessary, in order to maintain the appropriate concentration of anesthesia, respectively, in the cervix clockwise 3:00 , And at 4 o’clock Lidocaine Hydrochloride 40 mg (2% lidocaine hydrochloride 2 ml plus saline 4 ml) was instilled with a sterile cotton swab dipped in 2% lidocaine hydrochloride approximately 0.6 ml (containing lidocaine hydrochloride 12 mg ) Inserted into the cervical canal cervical mouth, remove after 1 min. Results analgesic effect is exact, add lidocaine hydrochloride can reduce the stimulation of propofol on blood vessels, plus fentanyl can increase the patient pain threshold, cervical lidocaine hydrochloride, cervix relaxation, short operative time, reduce The amount of propofol, reducing the cost of surgery and reduce the financial burden on patients. Conclusion The combination of three drugs can provide a steady anesthetic effect in painless induced abortion.