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1、异丙酚复合芬太尼用于无痛人工流产术临床观察【摘要】目的观察芬太尼、异丙酚用于人工流产麻醉的效果。方法选择我院2005年―2009年自愿采用异丙酚复合芬太尼麻醉进行人工流产术300例,ASAⅠ-Ⅱ级,年龄19-42岁,体重45-78kg,并且均无心、肺疾患,无高血压,无药物过敏史。病人麻醉诱导前常规持续鼻导管吸氧2--5L/min,用普通的5号头皮针静脉穿刺,缓慢推注芬太尼1ug/kg,后以异丙酚1.5-2ug/kg缓慢推注诱导麻醉,待病人意识消失,睫毛反射消失后开始手术,术中出现不自主肢体活动时给予异丙酚0.5m/kg追加。术后病人5min内清醒,观
2、察20-30min无异常离院。结果生命体征监测:注药初期出现短暂的呼吸、循环抑制,SBP、DBP、MAP、HR、SpO2下降明显,但均在2-3min内恢复正常,本组300例中16例(5.3%)的病人出现一过性的呼吸抑制,持续时间短暂多能自行恢复,仅有2例出现舌后缀,经提下颌并加大氧流量后呼吸恢复正常,术中出血无明显增多,术后宫缩良好。23例术后轻微头晕,休息后好转。结论芬太尼、异丙酚用于人工流产麻醉安全,可靠。【关键词】异丙酚;芬太尼;人工流产【中图分类号】R719.3+1【文献标识码】B【文章编号】1005-0515(2010)005-006-03
3、9【Abstract】ObjectiveToobservetheeffectofPropofolandFentanylduringinducedabortion.Methods300casesofpregnantwomenwereinvolved,voluntarilyprovidedwithpropofolandfentanylduringinducedabortionintheyears2005-2009inourhospital,andconsideredtohaveIorIIlevelofsurgerywithagesvaryingfrom1
4、9to42andweightvaryingfrom45to78kg.Allofthemwerefreeofheartandlungdiseases,hypertensionanddrugallergy.Conventionally,patientsbreathedinoxygen2--5L/minbynasalcannulaandwereinjectedfentanylslowlywiththenormalmodel5scalpneedlepuncturedinthevenipuncturebeforetheanesthesiainduction.A
5、fterthat,1.5-2ug/kgpropofolwasinjectedslowlytoinductanesthesia.Theoperationbeganwhenthepatientswereunconsciousandtheireyelashreflectiondisappearedaswell.0.5m/kgpropofolcouldbeadditiveifpatientsshowedphysicalactivitiesunconsciouslyduringtheoperation.Aftertheoperations,patientsaw
6、okewithin5minutesanddepartedfromthehospitalwhennoabnormalities9occurredwithin20-30min’observation.ResultsThemonitoringresultsofvitalsigns:patientsshowedtemporaryrestrainofbreathandcirculation;meanwhile,SBP、DBP、MAP、HR、SpO2alsodecreasedsignificantlyduringthefirstperiod,butallofth
7、esereturnedtonormalwithin2-3min.16casesoutof300(5.3%),temporaryrestrainofbreathhappenedtopatients,butthelastingtimewasshortandmostpatientsrecoveredautomatically.Only2caseshadfallingtonguesandpatients’breathreturnedtonormalaftertheirlowerjawswereliftedandmoreoxygenwasgiven.There
8、wasnomorebloodapparentlyduringtheoperationanduterineco
