医学论文-丙泊酚复合布托啡诺在人工流产术的应用.doc

医学论文-丙泊酚复合布托啡诺在人工流产术的应用 【摘要】? 目的 观察布托啡诺复合丙泊酚用于人工流产手术的麻醉效果。方法 选择门诊ASAⅠ级初孕或未经阴道产的已育孕妇需人工流产者180例，随机分成三组，每组60例。A组:静注丙泊酚1.0mg/kg，然后丙泊酚6mg/（kg·h）至负压吸收结束；B组:布托啡诺10μg/kg静注后按A组方法给予丙泊酚；C组:芬太尼1.0μg/kg静注后按A组方法给予丙泊酚。结果 A组注射部位痛和体动发生率明显高于B、C两组(P0.05)。C组HR与A、B两组间差异有显著性(P0.05)。MAP、SpO2、宫口松弛度、手术时间和清醒时间三组间无明显差别(P0.05)，术后三组孕妇对镇痛效果均表示满意，未见不良反应发生。结论 丙泊酚复合布托啡诺或芬太尼用于人流手术，麻醉效果优于单独使用丙泊酚。丙泊酚复合布托啡诺不良反应少，安全方便。 【关键词】? 丙泊酚 布托啡诺 人工流产术 麻醉 ??? 【Abstract】? Objective? To study the anesthesia effects of propofol combined with butorphanol during artificial abortion operation.Methods? One hundred and eighty early pregnancy out patients, ASAⅠgrade, undergoing elective artificial abortion operation, were randomly allocated into three groups, 60 patients each. Group A, anesthesia with propofol i.v.,dose 1.0mg/kg followed by an infusion of 6mg/(kg·h). Group B, butorphanol i.v.,dose 10μg/kg, then anesthesia with propofol, the regimen of propofol as same as group A. Group C, fentanyl i.v. dose 1.0μg/kg, then anesthesia with propofol, the regimen of propofol as same as group A.Results? Group A showed an significant increase in the rate of pain during injection of propofol and movement during operation compared with group B or group C, and group C showed an difference in HR compared with group A or group B. There was no difference in MAP, SpO2, the relaxation degree of cervix, duration of operation and perceptive time among three groups. No adverse effect was observed during and after the operation. Conclusions? Butorphanol combined with propofol anesthesia can achieve satisfactory anesthesia during artificial abortion operation. ??? 【Key words】? propofol; butorphanol; artificial abortion operation; anesthesia ??? 布托啡诺是阿片受体激动-拮抗剂，作用于κ受体而产生镇痛，镇痛强度比吗啡高5～8倍，对μ阿片受体有弱的拮抗性，可抑制恶心呕吐的发生，静注后1min起效，4～5min达到峰值［1］。由于其呼吸抑制作用较轻，很少产生依赖性，用于门诊手术安全方便。我科于2006年9月～2007年1月，对布托啡诺复合丙泊酚用于人工流产术的麻醉效果和不良反应进行了观察对比，现报告如下。 ??? 1? 资料与方法 ??? 1.1? 一般资料? 选择妇科门诊ASAⅠ级初孕或未经阴道产的已育妇女需人工流产者180例，年龄18～35岁，体重43～61kg，妊娠时间39～55天。随机分成三组，单纯丙泊酚组(A组，n=60例)，布托啡诺