论文部分内容阅读
目的探讨氟比洛芬酯超前镇痛联合丙泊酚靶控输注(TCI)在无痛人工流产术中的应用效果。方法选取2014年3月—2015年2月于苏州市立医院行无痛人工流产术的美国麻醉师协会(ASA)Ⅰ级,妊娠6~12周的患者90例,随机分为Ⅰ组、Ⅱ组和Ⅲ组,各30例。Ⅰ组患者予以氟比洛芬酯+丙泊酚麻醉,Ⅱ组患者予以枸橼酸芬太尼+丙泊酚麻醉,Ⅲ组患者予以丙泊酚麻醉。观察3组患者手术时间,苏醒时间,丙泊酚用量,视觉模拟评分法(VAS)评分,麻醉给药前(T0)、开始手术时(T1),扩宫口时(T2)、吸宫时(T3)、术毕(T4)、清醒(T5)、清醒后15min(T6)的心率(HR)和血氧饱和度(Sp O2)、体动次数和程度、呼吸抑制评分。结果 3组患者手术时间、苏醒时间、丙泊酚用量比较,差异无统计学意义(P>0.05),3组患者VAS评分比较,差异有统计学意义(P<0.05),Ⅲ组患者VAS评分高于Ⅰ、Ⅱ组,差异有统计学意义(P<0.05);HR的时间与麻醉方法有交互作用(P<0.05),Sp O2的时间与麻醉方法无交互作用(P>0.05),组间比较,差异均有统计学意义(P<0.05),时间间比较,差异均有统计学意义(P<0.05),Ⅲ组患者T1~6时间点HR高于Ⅰ、Ⅱ组,差异有统计学意义(P<0.05),Ⅰ组患者T1~3时间点Sp O2高于Ⅱ、Ⅲ组,T4Sp O2低于Ⅱ、Ⅲ组,差异有统计学意义(P<0.05),Ⅱ组患者T1、T3Sp O2低于Ⅲ组,差异有统计学意义(P<0.05);Ⅰ、Ⅱ组患者体动次数和程度优于Ⅲ组,差异有统计学意义(P<0.05);Ⅰ组患者呼吸抑制评分优于Ⅱ、Ⅲ组,差异有统计学意义(P<0.05)。结论氟比洛芬酯超前镇痛联合丙泊酚TCI在无痛人工流产术中的应用效果显著,可减少患者术中体动次数、减轻呼吸抑制程度,且安全性高。
Objective To investigate the application of flurbiprofen axetil in combination with propofol target controlled infusion (TCI) in painless artificial abortion. Methods A total of 90 American College of Anesthesiologists (ASA) patients with painless induced abortion at Suzhou Municipal Hospital from March 2014 to February 2015 were enrolled in this study. 90 patients were randomly divided into two groups: group Ⅰ and group Ⅱ And group Ⅲ, 30 cases each. Patients in group I received flurbiprofen axetil + propofol anesthesia, patients in group II received fentanyl citrate and propofol, and patients in group III received propofol anesthesia. The time of operation, the recovery time, the dosage of propofol, the visual analogue scale (VAS) score, the time before anesthesia (T0), the time of starting operation (T1) The heart rate (HR) and oxygen saturation (Sp O2), the frequency and extent of physical activity, respiratory depression score at T3, T4, T5 and T6 were measured. Results There was no significant difference in operative time, awakening time and dosage of propofol between the three groups (P> 0.05). There was significant difference in VAS score between the three groups (P <0.05), VAS score (P <0.05); HR time interacted with anesthesia method (P <0.05), Sp O2 time had no interaction with anesthesia method (P> 0.05), and the difference was statistically significant (P <0.05). There were significant differences in time between the two groups (P <0.05). The HR of T1 ~ 6 in group Ⅲ was higher than that in groups Ⅰ and Ⅱ, the differences were statistically significant (P <0.05). The level of Sp O2 in group Ⅰ was higher than that in groups Ⅱ and Ⅲ at T1 ~ 3, and that in group Ⅱ was lower than that in group Ⅱ and Ⅲ (P0.05) (P <0.05). The frequency and degree of body movement in group Ⅰ and group Ⅱ were better than those in group Ⅲ (P <0.05). The level of T3 in group Ⅰ was significantly lower than that in group Ⅲ Which were better than those in group Ⅱ and group Ⅲ, the difference was statistically significant (P <0.05). Conclusion The application of flurbiprofen axetil analgesia in combination with propofol TCI in painless artificial abortion has significant effect, which can reduce the frequency of physical activity, reduce the degree of respiratory depression and have high safety.