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目的探讨人工流术中不同给药方法的丙泊酚用量、麻醉效果、镇痛效果、术中生命体征的变化及清醒恢复时间。方法选择门诊ASAⅠ～Ⅱ级早孕自愿无痛人流患者120例,随机分为丙泊酚加雷米芬太尼组(A组)和丙泊酚加芬太尼组(B组)。A组静脉注射雷米芬太尼0.5μg/kg,继之缓慢静脉注射丙泊酚1.5mg/kg;B组静脉注射芬太尼1μg/kg,丙泊酚用法同A组。结果A组术后2min SpO2下降明显(P<0.05);两组术后2min与术前的SBP、DBP、HR比较有显著性差异(P<0.05);手术结束与术前的比较无显著性差异(P>0.05);组间同一时点比较无显著性差异(P>0.05)。两组麻醉效果、镇痛效果相比,未见明显差异(P>0.05)。A、B两组患者术中丙泊酚总量分别为(2.55±0.65)和(3.46±0.93)mg/kg,组间比较有显著性差异(P<0.05)。A组和B组清醒时间分别为(6.85±1.08)和(7.60±1.60)min,组间比较有显著性差异(P<0.05)。患者离院时间,A组为(13.5±2.1)min,B组为(20.3±2.5)min,组间比较有显著性差异(P<0.05)。结论两种配伍方法各有利弊,在临床实践中根据情况选择。
Objective To investigate the dosage of propofol, anesthesia effect, analgesic effect, changes of intraoperative vital signs and awake recovery time of different administration methods in artificial abortion. Methods A total of 120 ASA Ⅰ ~ Ⅱ volunteers with painless abortion were randomly divided into propofol plus remifentanil group (group A) and propofol plus fentanyl group (group B). Group A received intravenous injection of remifentanil 0.5 μg / kg followed by slow intravenous injection of propofol 1.5 mg / kg; Group B received fentanyl 1 μg / kg intravenously and propofol used as group A. Results The SpO2 decreased significantly in group A at 2 minutes after operation (P <0.05). There was a significant difference in SBP, DBP and HR at 2 minutes after operation between two groups (P <0.05); there was no significant difference between the two groups (P> 0.05). There was no significant difference between the two groups at the same time point (P> 0.05). There was no significant difference between the two groups in anesthetic effect and analgesic effect (P> 0.05). The total amount of propofol in patients A and B during surgery was (2.55 ± 0.65) and (3.46 ± 0.93) mg / kg, respectively, with significant difference between the two groups (P <0.05). The awake time in group A and group B was (6.85 ± 1.08) and (7.60 ± 1.60) min respectively, with significant difference between the two groups (P <0.05). The time of leaving hospital was (13.5 ± 2.1) min in group A and (20.3 ± 2.5) min in group B, there was a significant difference between the two groups (P <0.05). Conclusion Both methods have their own advantages and disadvantages, in clinical practice, choose according to the situation.