氯诺昔康用于无痛人工流产的可行性研究.doc

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1、氯诺昔康用于无痛人工流产的可行性研究【摘要】目的探讨氯诺昔康复合丙泊酚麻醉用于无痛人流的可行性。方法将90例无痛人流患者随机分为3组，每组各30例，组Ⅰ：氯诺昔康（可赛风）0.15mg/kg；组Ⅱ：芬太尼1μg/kg；组Ⅲ：氯胺酮0.4mg/kg，3组均给予复合丙泊酚静脉麻醉。监测患者术前、扩宫颈、注射缩宫素和术毕的生命体征变化，记录丙泊酚用量、睁眼时间、术后不良反应的发生情况，评定术中及术后10min的镇痛效果。结果3组间MAP、HR、RR、术中镇痛效果、丙泊酚用量及睁眼时间差异均无显著性（P>0.0

2、5）；Ⅰ组术后10min镇痛效果明显优于Ⅱ、Ⅲ组（P<0.05）；3组患者术后不良反应的发生率差异无显著性（P>0.05）。结论氯诺昔康复合丙泊酚麻醉可安全用于无痛人流，尤其减轻术后宫缩痛方面优于芬太尼和氯胺酮。　　【关键词】氯诺昔康；无痛人工流产　　Effectsoflornoxicamonaponiaartificialabortion　　【Abstract】ObjectiveToevaluatetheanalgesiceffectandsafetyoflornoxicaminpatients

3、undergoingaponiaartificialabortion.Methods90ASAⅠpatientsaged(25±4)yr,weighing(51±8)kgundergoingaponiaartificialabortionwererandomlydividedintothreegroups:groupⅠreceivedlornoxicam0.15mg/kgintravenouslyandthenintravenouspropofolanesthesia;groupⅡreceivedfentan

4、yl1μg/kgandthenintravenouspropofolanesthesia;groupⅢreceivedketamine0.4mg/kgandthenintravenouspropofolanesthesia.Meanbloodpressure(MAP),heartrate(HR)andrespiratoryrate(RR)weremonitoredbeforeanesthesia,duringcervicaldilation,atocytocininjectionandattheendofth

5、eoperation.Theconsumptionofpropofolandtimetoeyesopeningwererecorded.Theanalgesiceffectandadversedrugreactionwereobservedintra-and10minpostoperatively.ResultsNosignificantdifferenceswerefoundamongthreegroupsinMAP,HR,RR,theanalgesiceffectduringoperation,thepr

6、opofolconsumptionandthetimetoeyesopening(P>0.05).ThepostoperativeanalgesiceffectsofgroupⅠwerebetterthanthatofgroupⅡandⅢ(P>0.05)whiletherewasnodifferencebetweengroupⅡandⅢ(P>0.05).ComparingwithpatientsingroupⅠ,patientsingroupⅡandⅢhadnosignificantdiff

7、erenceintherateofnausea(P<0.05).ConclusionLornoxicamgivenintravenouslybeforepropofolanesthesiacanbesafelyusedinaponiaartificialabortionandcanprovidemoreadequatepainreliefpostoperativelythanthatoffentanylandketamine.4　　【Keywords】lornoxicam;aponiaartificia

8、labortion近年来开展的无痛人流多采用芬太尼、氯胺酮等复合丙泊酚麻醉。氯诺昔康是一种新型中效非甾体类抗炎镇痛药，通过激活阿片神经肽系统，发挥中枢镇痛作用，具有阿片类药物相当的镇痛效应［1，2］，而无呼吸抑制作用，近年来多用于术后镇痛而未见用于人工流产的报道。本研究旨在探讨氯诺昔康复合丙泊酚麻醉用于无痛人流的可行性。　　1资料与方法　　1.1一般资料选择90例无痛人流患者，年龄21~29岁，体重