异丙酚复合芬太尼用于无痛人工流产术临床观察.docVIP

异丙酚复合芬太尼用于无痛人工流产术临床观察【摘要】 目的 观察芬太尼、异丙酚用于人工流产麻醉的效果。方法 选择我院2005年―2009年自愿采用异丙酚复合芬太尼麻醉进行人工流产术300例,ASAⅠ-Ⅱ级,年龄19-42岁,体重45-78kg,并且均无心、肺疾患,无高血压,无药物过敏史。病人麻醉诱导前常规持续鼻导管吸氧2--5L/min,用普通的5号头皮针静脉穿刺,缓慢推注芬太尼1ug/kg,后以异丙酚1.5-2ug/kg缓慢推注诱导麻醉,待病人意识消失,睫毛反射消失后开始手术,术中出现不自主肢体活动时给予异丙酚0.5m/kg追加。术后病人5min内清醒,观察20-30min无异常离院。结果生命体征监测:注药初期出现短暂的呼吸、循环抑制,SBP、DBP 、MAP、HR、SpO2下降明显,但均在2-3min内恢复正常,本组300例中16例(5.3%)的病人出现一过性的呼吸抑制,持续时间短暂多能自行恢复,仅有2例出现舌后缀,经提下颌并加大氧流量后呼吸恢复正常,术中出血无明显增多,术后宫缩良好。23例术后轻微头晕,休息后好转。结论 芬太尼、异丙酚用于人工流产麻醉安全,可靠。 【关键词】异丙酚;芬太尼;人工流产 【中图分类号】R719.3+1【文献标识码】 B 【文章编号】1005-0515(2010)005-006-03 【Abstract】 ObjectiveTo observe the effect of Propofol and Fentanyl during induced abortion. Methods 300 cases of pregnant women were involved, voluntarily provided with propofol and fentanyl during induced abortion in the years 2005-2009 in our hospital, and considered to have I or II level of surgery with ages varying from 19 to 42 and weight varying from 45 to 78 kg. All of them were free of heart and lung diseases, hypertension and drug allergy. Conventionally, patients breathed in oxygen 2--5L/min by nasal cannula and were injected fentanyl slowly with the normal model 5 scalp needle punctured in the venipuncture before the anesthesia induction. After that, 1.5-2ug/kg propofol was injected slowly to induct anesthesia. The operation began when the patients were unconscious and their eyelash reflection disappeared as well. 0.5m/kg propofol could be additive if patients showed physical activities unconsciously during the operation. After the operations, patients awoke within 5 minutes and departed from the hospital when no abnormalities occurred within 20-30min? observation. ResultsThe monitoring results of vital signs: patients showed temporary restrain of breath and circulation; meanwhile, SBP、DBP 、MAP、HR、SpO2 also decreased significantly during the first period, but all of these returned to normal within 2-3min. 16 cases out of 300 (5.3%), temporary restrain of breath happened to patients, but the