丙泊酚联合小剂量布托啡诺用于无痛人工流产的效果观察

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1、丙泊酚联合小剂量布托啡诺用于无痛人工流产的效果观察作者：祁宾,卢杰,宗,林,张应祥,王玉秀单位：解放军第82医院麻醉科，江苏淮安【摘要】目的探讨丙泊酚联合小剂量布托啡诺用于无痛人工流产术可行性及其与现常用方法相比的优缺点。方法160例ASAⅠ级早期妊娠患者随机分为四组，每组40例。A组（丙泊酚+芬太尼组）静脉推注芬太尼0.001mg/kg后推注丙泊酚；B组（丙泊酚组）直接静脉推注丙泊酚；C组、D组（丙泊酚+布托啡诺组）分别推注布托啡诺0.01mg/kg和0.02mg/kg后推注丙泊酚。丙泊酚首剂量为B组2.5mg/kg，其余各

2、组2mg/kg，术中出现肢体扭动者酌情追加丙泊酚30～50mg。观察比较麻醉前后呼吸循环变化、麻醉镇痛效果、术后恢复情况及不良反应等。结果四组患者都成功完成手术。各组用药后均有一定的循环抑制，以B组为著（P<0.05）。A组呼吸抑制发生率显著高于其他组（P<0.01）；B组术中镇痛不全和术后腹痛发生率显著高于其他各组（P<0.05）；D组苏醒及离院时间显著长于A、B、C组（P<0.01）。结论丙泊酚联合小剂量布托啡诺（0.01mg/kg）完全能满足无痛人工流产术麻醉需要，并较好地解决单用丙泊酚所致镇痛不

3、全和减少了加用芬太尼引起的呼吸抑制，值得推广应用于各类门诊小手术和无痛诊疗技术。【关键词】丙泊酚；布托啡诺；无痛人工流产EffectofpropofolcombinedwithsmalldosesofbutorphanolonpainlessartificialabortionQIBin,LUJie,ZONGLin,ZHANGYingxiang,WANGYuxiu(DepartmentofAnesthesiology，the82thHospitalofPLA，Huaian223001,Jiangsu,China)［Abst

4、ract］ObjectiveToexplorethefeasibilityaswellastheadvantagesanddisadvantagesofpropofolcombinedwithsmalldosesofbutorphanolonpainlessabortion.Methods160casesofearlypregnantwomenwithASA(gradeI)wererandomlydividedintofourgroups(40caseseachgroup).PatientsingroupAaccepted0

5、.001mg/kgfentanylfollowedbypropofolintravenously;PatientsingroupBacceptedintravenouspropofol;PatientsingroupCandDaccepted0.01mg/kgor0.02mg/kgbutorphanolbeforeintravenouspropofolrespectively.TheinitialdoseofpropofolingroupBwas2.5mg/kgand2mg/kginothers,andadditionaldo

6、seswillbeappliedwhenbodymotionoccurred.Thechangesofrespiratoryandcirculatoryfunction,anesthesiaandanalgesiaeffects,postoperativerecoveryprofileandsideeffectswereobservedbeforeandafteranesthesia.ResultsTheoperationsweresuccessfulinallthepatients.Eachgroupshowedcircu

7、latorydepressiontoacertainextentafteranesthesia,andthemostonewasgroupB(P<0.05).TheincidenceofrespiratorydepressioningroupAwasthehighest(P<0.01).AndtheincidenceofintraoperativeinsufficientanalgesiaandpostoperativeabdominalpainingroupBwasthemostsignificant(P<

8、0.05).Inaddition,theawaketimeanddeparturetimewasthelongestingroupD(P<0.05).ConclusionPropofolcombinedwithsmalldosesofbutorphanol(0.01mg