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目的:观察利多卡因宫颈旁阻滞辅助丙泊酚用于人工流产增强麻醉效果及减少丙泊酚用量的可行性。方法:选择在我院门诊2007年1月~2007年11月行人工流产术患者200例,年龄在19岁~40岁之间,体重48kg-70kg,停经时间48天~55天,B超检查证实为宫内妊娠,无人工流产禁忌症,随机分为两组:宫颈阻滞联合丙泊酚组(A组)和丙泊酚组(B组),观察其镇痛效果、宫颈松弛程度、手术操作时间、丙泊酚使用剂量、苏醒时间。结果:麻醉镇痛效果及宫颈松弛度A组均优于B组,B组术中需追加用药者(65例)比A组(27例)多(P<0.01),故丙泊酚用量B组也较A组大(P<0.05);苏醒时间A组短于B组(P<0.05)。结论:丙泊酚具有麻醉起效快,作用维持时间短苏醒迅速完全等优点,但无明显的镇痛作用,且无宫颈松弛作用。用利多卡因作宫颈旁阻滞可以起到局部镇痛及松弛宫颈的作用,弥补了丙泊酚的弱点,有助于增强丙泊酚的麻醉镇痛效果,减少丙泊酚术中的用量,从而减少了麻醉药物的不良反应,因此利多卡因宫颈旁阻滞加异丙酚组能较好的达到人工流产术的无痛效果。而且,利多卡因宫颈旁阻滞辅助丙泊酚在宫颈松弛程度、手术操作时间、丙泊酚使用剂量、苏醒时间均优于单纯应用丙泊酚组。
OBJECTIVE: To observe the feasibility of using propofol with lidocaine to improve the anesthetic effect and reduce the dosage of propofol during induced abortion. Methods: 200 cases of abortion in our hospital from January 2007 to November 2007 were selected, aged 19 to 40 years old, weighing 48kg-70kg, menopause time 48 days to 55 days, B-ultrasound Confirmed intrauterine pregnancy, no contraindications to abortion, were randomly divided into two groups: cervical block combined with propofol group (group A) and propofol group (group B), observed its analgesic effect, cervical relaxation, Operation time, dosage of propofol, recovery time. Results: Anesthesia analgesic effect and cervix laxity were better in group A than in group B. In group B, there were more patients requiring additional medication (65 cases) than those in group A (27 cases) (P <0.01). Therefore, the dosage of propofol B (P <0.05). The recovery time in group A was shorter than that in group B (P <0.05). Conclusion: Propofol has the advantages of rapid onset of anesthesia, rapid and complete recovery of action duration, but no significant analgesic effect and no cervical relaxation. Cervical block with lidocaine can play a role in local analgesia and relaxation of the cervix to make up for the weakness of propofol, help to enhance the anesthetic analgesic effect of propofol and reduce the amount of propofol intraoperative , Thus reducing the adverse effects of narcotic drugs, so lidocaine and paracetamol plus propofol group can better achieve the painless effect of abortion. Moreover, lidocaine cervical support block propofol in the degree of cervical relaxation, operation time, dosage of propofol, recovery time are better than the simple propofol group.