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目的:探讨羟考酮复合异丙酚用于人工流产术的最适宜剂量。方法:选取2014年10月至2015年10月就诊于我院的250例行人工流产术患者,随机均分为5组各50例。异丙酚组(A组)静脉注射异丙酚1 mg·kg~(-1),不同剂量羟考酮组(B、C、D、E组)在A组基础上分别静脉注射羟考酮20、50、100、150μg·kg~(-1),待患者睫毛反射现象消失后即开始手术。比较各组宫缩痛程度、呼吸循环及不良反应情况。结果:与术后30 min时的疼痛数字评分(NRS)比较,A组术后1、4 h时的NRS评分升高(P<0.05);术后30 min,B、C、D、E组患者NRS评分均显著高于A组(P<0.05),并且B、C组患者NRS评分显著高于D、E组(P<0.05)。术后1 h,D、E两组患者NRS评分显著低于A、B、C 3组(P<0.05)。术后4 h,B、C、D、E组患者NRS评分均显著低于A组(P<0.05),C组患者NRS评分显著高于B、D、E 3组,差异具有统计学意义(P<0.05)。与其他组比较,E组患者在术中的平均动脉压(MAP)明显升高,但血氧饱和度(Sp O2)降低(P<0.05),其余4组之间MAP、Sp O2比较差异无统计学意义(P>0.05);所有患者的心率(HR)、呼吸频率(RR)在不同组间比较差异均无统计学意义(P>0.05)。与其他组比较,E组患者的呼吸停顿、呼吸抑制、辅助呼吸发生率明显增加(P<0.05),其余4组术中不良反应发生率比较差异无统计学意义(P>0.05);各组患者术后不良反应发生率比较差异无统计学意义(P>0.05)。结论:20μg·kg~(-1)的羟考酮复合异丙酚对人工流产患者术后宫缩痛的镇痛效果较好,对呼吸循环的影响较小,术中及术后不良反应的发生率较低,患者术后恢复快。
Objective: To investigate the optimal dosage of oxycodone and propofol for artificial abortion. Methods: A total of 250 patients undergoing induced abortion visited our hospital from October 2014 to October 2015 were randomly divided into five groups of 50 patients. The propofol group (group A) received propofol 1 mg · kg -1, and the oxycodone groups (group B, C, D, E) received intravenous oxycodone 20,50,100,150μg · kg ~ (-1), until the eyelash reflex disappeared after the operation began. Compare the degree of contractions pain, respiratory cycle and adverse reactions in each group. Results: Compared with NRS at 30 min after operation, the NRS score of group A at 1 h and 4 h after operation increased (P <0.05). At 30 min after operation, the scores of NRS at B, C, D and E The NRS scores of patients were significantly higher than those of patients in group A (P <0.05). The NRS scores of patients in groups B and C were significantly higher than those in patients in groups D and E (P <0.05). At 1 hour after operation, the NRS scores of D and E groups were significantly lower than those of A, B and C groups (P <0.05). The scores of NRS in group B, C, D and E were significantly lower than those in group A at 4 h after operation (P <0.05). The NRS score in group C was significantly higher than that of group B, D and E 3 P <0.05). Compared with other groups, the mean arterial pressure (MAP) of patients in group E increased significantly during operation, but the oxygen saturation (Sp O2) decreased (P <0.05). The difference of MAP and Sp O2 between the other four groups was no significant difference (P> 0.05). There was no significant difference in heart rate (HR) and respiratory rate (RR) among different groups (P> 0.05). Compared with other groups, the incidence of respiratory arrest, respiratory depression and respiratory assistance in group E were significantly increased (P <0.05), while the incidence of adverse reactions in other four groups was not statistically significant (P> 0.05) The incidence of postoperative adverse reactions in patients with no significant difference (P> 0.05). CONCLUSION: Oxycodone and propofol at a dosage of 20μg · kg ~ (-1) have a better analgesic effect on postoperative uterine pain in induced abortion patients with less impact on respiratory circulation, and intraoperative and postoperative adverse reactions The incidence is low, the patient recovered quickly.