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目的:探讨丙泊酚复合帕瑞昔布钠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:120例ASA I～II级早期妊娠患者,随机分为3组,每组40例。A组(丙泊酚+芬太尼组)静脉推注芬太尼0.05 mg后推注丙泊酚;B组(丙泊酚组)直接静脉推注丙泊酚;C组(丙泊酚+帕瑞昔布钠)在术前10分静推注帕瑞昔布钠40 mg后推注丙泊酚。丙泊酚首剂量为B组2.5 mg.kg-1,其余各组2 mg.kg-1,术中出现肢体扭动者酌情追加丙泊酚30～50 mg。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:3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);苏醒时间C组快于A组与B组,丙泊酚用量A、C两组均少于B组(P<0.05)。结论:丙泊酚复合帕瑞昔布钠完全能满足无痛人工流产术麻醉需要,其可提供较好的术后镇痛,较好地解决了单用丙泊酚所致镇痛不全的缺点,并减少了加用芬太尼引起的呼吸抑制。
Objective: To investigate the feasibility of propofol combined with parecoxib sodium for painless artificial abortion and its advantages and disadvantages compared with the commonly used methods. Methods: One hundred and twenty patients with ASA I ~ II early pregnancy were randomly divided into 3 groups (40 in each group). Group A (propofol + fentanyl group) was injected with 0.05 mg fentanyl intravenously after propofol; Group B (propofol group) was directly injected with propofol; Group C (propofol + Parecoxib Sodium) Propofol was bolted 10 minutes prior to pessary 40 mg of parecoxib sodium. The first dose of propofol was 2.5 mg.kg-1 in group B, while the others in each group were 2 mg.kg-1. When limb twisting occurred, propofol was supplemented with 30-50 mg as appropriate. The changes of respiratory cycle before and after anesthesia, anesthesia analgesia, postoperative recovery and adverse reactions were observed and compared. Results: The three groups of patients completed the operation successfully. Each group after treatment have a certain degree of inhibition of circulation, B group (P <0.05). The incidence of respiratory depression in group A was significantly higher than that in other groups (P <0.01). The incidence of intraoperative analgesia and postoperative abdominal pain in group B was significantly higher than that in other groups (P <0.05) Compared with group B, propofol dosage A and C were less in both groups than in group B (P <0.05). Conclusion: Propofol combined with parecoxib sodium can completely meet the need of painless artificial abortion anesthesia, which can provide better postoperative analgesia, solves the shortcomings of analgesia caused by propofol alone , And reduces the respiratory depression caused by the addition of fentanyl.