地佐辛预先镇痛用于无痛人工流产术的临床观察.doc

地佐辛预先镇痛用于无痛人工流产术的临床观察 陶 清 梅高昌 陈庆一 【摘　要】　目的　比较地佐辛与芬太尼预先镇痛复合丙泊酚静脉全麻在无痛人工流产术的效果及不良反应的影响。方法　人工流产术的孕妇90例,随机均分为3组，每组30例。D组预先静脉注射地佐辛0.1mg/kg, F组预先静脉注射芬太尼1μg/kg，P组为对照组。各组均静脉注射丙泊酚2mg/kg,必要时追加0.5-1.0mg/kg。观察各组呼吸循环变化。记录丙泊酚总用量、麻醉诱导时间、唤醒时间及宫缩痛与不良反应。结果　D组和F组术中血压、心率、丙泊酚总用量、丙泊酚注射痛和体动发生率较P组显著降低或缩短。F组术中呼吸抑制发生率显著高于其余2组。结论　地佐辛预先镇痛复合丙泊酚麻醉用于无痛人工流产术优于芬太尼复合丙泊酚麻醉和单纯丙泊酚麻醉，而且无芬太尼的呼吸抑制作用。 【关键词】　地佐辛；　丙泊酚；　预先镇痛；　人工流产 Observation of dezocine pre-emptive analgesia on artificial abortion TAO Qing,MEI Gao-chang,CHEN Qing-yi.Department of Anesthesiology,First Affiliated Hospital of Anhui Traditional Chinese Medical College,Hefei 230031,China 【Abstract】　Objective To observe and compare the effect of ezocine with fentanyl in pre-emptive analgesia combined with propofol intravenous anesthesia and its adverse reaction on artificial abortion. Methods ninety pregnant woman seheduled for abortion were randomly divided into three groups,30 cases in each:Group D with intravenous dezocine 0.1 mg/kg,Group F with intravenous fentanyl 1 μ g/kg,Group P without analgesics,after that intravenous propofol 2 mg/kg, and additional propofol 0.5-1.0 mg/kg.if necessary was given.The changes of respiratory and circulatory system were mornitored.The total amount of propofol,induction time,wake up time,uterine contractions pain and adverse reactions were recorded. Results HR,MAP,propofol consumption and the incidences of side effects during the operation in Group D,F were significantly reduced or shorten than those in Group P, in Respiratory inhibition rate Group F was significantly higher than that in the others. Conclusion Dezocine pre-emptive analgesia combined with propofol intravenous anesthesia during artificial abortion has a better effect than fentanyl combined with propofol anesthesia and propofol anesthesia alone,and has no respiratory inhibition like. 【Key words】Dezocine;Propofol; Pre-emptive analgesia; artificial abortion 丙泊酚具有起效快，作用时间短，苏醒快的特点，已被广泛应用于临床人工流产术，但由于其镇痛作用弱，且易发生呼吸、循环抑制，所以常需联合镇痛药使用。地佐辛(dezocine)是一