资源描述:
《丙泊酚-芬太尼在输卵管结扎术中的应用体会》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、丙泊酚芬太尼在输卵管结扎术屮的应用体会作者单位:235162安徽省宿州市皖北煤电集团总医院刘桥矿医院通讯作者:吴云【摘要】目的探讨丙泊酚、芬太尼麻醉行输卵管结扎术的临床应用镇痛效果。方法将99例受术者随机分成为丙泊酚组57例,局部麻醉组42例。局部麻醉组常规局麻经下腹行输卵管结扎术。丙泊酚组在局部浸润麻醉的基础上,切开皮肤前给予静脉注射丙泊酚注射液1.8mg/kg,芬太尼注射液0.001mg/kg,切开腹膜进入腹腔前,再用微量静脉注射泵给了丙泊酚注射液0.2mg/(kg・min)的速度持续至手术结束时停药。观察两组受术者的术屮镇痛效果、血压、心率、血氧饱和
2、度和呼吸频率变化、药物不良反应、手术时间、苏醒和定向力恢复时间。结果局部麻醉组42例,II级9例(21.4%),UI级28例(66.7%),IV级5例(11.9%),丙泊酚组57例术中无痛感达100%,手术时间明显缩短,无明显副作用。结论静脉注射丙泊酚、芬太尼镇痛麻醉加局麻行输卵管结扎术安全、效果可靠,无明显呼吸及循坏系统抑制作用。【关键词】输卵管结扎术;局部麻醉;异丙酚、芬尼太麻醉;镇痛Propofol,fentanyl,tubal1igationintheexperienccintheapplicationWUYun.WanbeiCoalMineGrou
3、p,GeneralHospitalLiuqiao,Suzhou235162,China【Abstract]ObjectiveOfpropofol,fentanylanesthesiaclinicalapplicationoftuballigationanalgesia.Methods99casesbypatientswhowererandomlydividedinto57patientsinthepropofolgroup,42patientsunderlocalanesthesia・Generalanesthesialocalanesthesiagroup
4、1inesbyabdominaltubal1igation.Propofolgrouponthebasisoflocalanesthesia,skinincisionandbeforeintravenousinjectionofpropofol1.8mg/kg,fentanylinjection0.001mg/kg,peritoneumintotheabdominalcavitybeforetheincision,andthentraceveininjectionpumpinjectionofpropofolgiven0.2mg/(kg•min)rateof
5、withdrawalcontinueuntiltheendofsurgery.Wereobservedbythesurgcorfsanalgesiceffect,bloodpressure,heartrate,oxygensaturationandrespiratoryratechanges,adversedrugreactions,surgerytime,recoverytimeofawakeningandorientation.ResuItsOflocalanesthesisgroup,42cases,II9cases(21.4%),IIIgrade28
6、cases(66.7%),IV5cases(11.9%),propofolgroup57patientssurgerywas100%pain-freeoperationtimesignificantlyreduced,noobvioussideeffects・ConelusionIntravenousinjectionofpropofol,fentanylanesthesiapluslocalanesthesialinetuballigationsafe,effectiveandreliable,nosignificantinhibitionofrespir
7、atoryandcirculatorysystems.[Keywords]Tuballigation;Localanesthesia;Propofol,Finneyistooanesthesia;Analgesic经腹输卵管结扎术是一种简便、安全、节育对象易接受的绝育手术。以往的输卵管结扎术都是在切II局部麻醉下行手术,虽然手术时间短,但因局麻药物只能抑制腹壁切II疼痛,而进入腹腔因牵拉输卵管而引起的疼痛,诱发恶心、呕吐,鼓腹致腹腔内容物外溢,增加取管难度,严重者不能配合手术,延长手术时间,增加受术者的痛苦。为解决和减少受术者的疼痛和心理压力,笔者在原局部麻
8、醉方法的基础上应用静脉注射丙泊酚、芬太尼注射液,达到