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目的观察异丙酚复合芬太尼用于无痛人工流产术的麻醉效应和对呼吸、循环系统的影响以及临床效果和安全性。方法选择行无痛人工流产术的早孕妇女60例,随机分为瑞芬太尼组(P+R组)和芬太尼组(P+F组)各30例。P+R组:瑞芬太尼1.0μg/kg,异丙酚2～3mg/kg。P+F组:芬太尼1.0μg/kg,异丙酚2～3mg/kg。分别记录术前、扩宫时、吸宫时和术后的HR、SBP、DBP和SpO2及麻醉效果,异丙酚总量、手术时间、苏醒时间以及术后并发症(恶心、呕吐、宫缩痛),并观察麻醉满意率。结果两组药物用于人工流产手术静脉麻醉,起效迅速,效果确切,术后恢复迅速且平顺,无严重不良反应,两组病例扩宫时HR、SBP、DBP和SpO2均较术前下降(P<0.01),苏醒时间P+R组短于P+F组(P<0.05),麻醉满意率两组均为100%。结论瑞芬太尼和芬太尼复合异丙酚用于无痛人工流产术效果好,安全可行,以瑞芬太尼复合异丙酚更优,但术中需严密监测呼吸、循环和加强管理。
Objective To observe the anesthetic effects of propofol combined with fentanyl on painless induced abortion and its effects on respiratory and circulatory system as well as its clinical effects and safety. Methods Sixty pregnant women with painless induced abortion were randomly divided into three groups: the remifentanil group (P + R group) and the fentanyl group (P + F group). P + R group: remifentanil 1.0μg / kg, propofol 2 ~ 3mg / kg. P + F group: fentanyl 1.0μg / kg, propofol 2 ~ 3mg / kg. The HR, SBP, DBP and SpO2 and the anesthetic effects, total propofol, operation time, recovery time and postoperative complications (nausea, vomiting, contractions Pain), and observed anesthesia satisfaction rate. Results The two groups of drugs were used for intravenous anesthesia in induced abortion, with rapid onset and definite effect, rapid and smooth postoperative recovery, and no serious adverse reactions. The HR, SBP, DBP and SpO2 in the two groups were significantly lower than those before operation P <0.01). The recovery time in P + R group was shorter than that in P + F group (P <0.05). The satisfactory rate of anesthesia was 100% in both groups. Conclusion The combination of remifentanil and fentanyl propofol for painless artificial abortion is effective, safe and feasible, and remifentanil combined with propofol is better, but respiratory, circulatory and intensive management should be closely monitored during operation .