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目的观察吸入氧化亚氮联合丙泊酚与芬太尼用于无痛人工流产的麻醉效果与安全性。方法选择自愿实施无痛人工流产的孕妇120例,随机分为A、B两组,A组为对照组60例,为丙泊酚+芬太尼;B组为治疗组60例,丙泊酚+芬太尼+氧化亚氮。记录两组患者术前、术中的心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO2),手术中镇痛的效果,患者术后清醒时间及术后定向力的恢复时间,记录丙泊酚用量,观察和记录术后不良反应。结果 A组HR、MAP术中均有所下降,B组HR、MAP麻醉前后变化比较,无统计学意义,A、B两组SPO2麻醉前后变化比较,无统计学意义(P>0.05)。A、B两组丙泊酚总量对比,以及清醒时间、准确定向时间对比,差异有统计学意义(P<0.05)。麻醉效果B组优于A组,术后注射部位痛、呼吸抑制的发生率两组对比,差异均有统计学意义(P<0.05)。结论丙泊酚和芬太尼复合氧化亚氮麻醉用于人工流产术中,具有对呼吸、循环抑制轻,术中、术后镇痛效果好,苏醒快等优点,并可减少丙泊酚的用量,是无痛人工流产较理想的麻醉方法。
Objective To observe the anesthetic effect and safety of inhaled nitrous oxide combined with propofol and fentanyl for painless induced abortion. Methods A total of 120 pregnant women who volunteered to have painless induced abortion were randomly divided into A and B groups. Group A was control group with 60 cases as propofol and fentanyl, group B with 60 cases as treatment group, propofol + Fentanyl + Nitrous oxide. The preoperative and intraoperative heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SPO2), analgesia in operation, recovery time of postoperative awake and postoperative recovery time , Record the dosage of propofol, observe and record the adverse reaction after operation. Results The HR and MAP in group A decreased. The changes of HR and MAP in group B before and after anesthesia were not statistically significant. There was no significant difference between group A and group B before and after SPO2 anesthesia (P> 0.05). The total amount of propofol in groups A and B were compared, and the comparison between awake time and accurate orientation time was statistically significant (P <0.05). The effects of anesthesia in group B were better than those in group A. The difference of postoperative injection site pain and respiratory depression was statistically significant (P <0.05). Conclusion Propofol and fentanyl in combination with nitrous oxide anesthesia for artificial abortion, with respiration, inhibition of light, intraoperative and postoperative analgesic effect is good, rapid recovery, and can reduce the propofol Amount of painless abortion is the ideal method of anesthesia.