双异丙酚联合芬太尼在人工流产术中的应用.docVIP

双异丙酚联合芬太尼在人工流产术中的应用 【关键词】 扩张宫颈 【摘要】目的 探讨应用双异丙酚联合芬太尼在人工流产术中的镇痛效果及宫颈扩张作用。方法 选择要求终止妊娠的早孕妇女300例，随机分为2组，分别在人工流产术时单独应用双异丙酚及双异丙酚联合芬太尼。观察术中镇痛效果、扩宫的难易程度、手术时间及手术并发症。结果 联合应用组的宫颈完全松弛率均明显大于单独应用双异丙酚组（P0.01），术中不良反应少（P0.01）；无痛率明显大于双异丙酚组（P0.01）。结论 双异丙酚联合芬太尼能有效提高手术质量，减少并发症。 【关键词】 扩张宫颈；双异丙酚；芬太尼 Application of propofol combined with fentanyl in induced abortion LI Yang,WANG Ai-tao,WANG Ling-ping. Department of Anesthesiology,Qishi Hospital,Dongguan 523500,China 【Abstract】 Objective To study the effect of Propofol combined with Fentanyl to soften and facilitate cervix dilatation and to relieve pain in induced abortion.Methods 150 women induced abortion were randomly allocated to two groups,one receiving propofol intravenous anesthesia only,the other receiving propofol combined with fentanyl. We observed the facility and the duration of operation,complications of the operation.Results The cervical dilatation was more difficult and the time required for operation was significantly longer in the group which received propofol in rectum before operation than the group of propofol combined with fentanyl (P＜0.01).The rate of pain relief was significantly higher in the group which received propofol combined with fentany intraverous anesthesia than the group receiving propofol only (P＜0.01).Conclusion Receiving propofol in the rectum before induced abortion would significantly facilitate cervical dilatation,and the application of propofol combined with fentanyl total intravenous anesthesia can benefit the operation of induced abortion with less complication. 【Key words】 cervical dilatation;propofol;fentanyl 人工流产术是避孕失败的补救措施，但无麻醉镇痛，孕妇会感到紧张和痛苦，且易发生人工流产综合征等不良反应，因此，应用无痛术相当必要，目前国内文献报道了多种镇痛方法。近年来，双异丙酚已广泛应用于人工流产术的静脉麻醉，单用仍未达到理想效果，我们采用双异丙酚联合芬太尼静脉麻醉用于人工流产术，并进行对照研究，以寻求最适当的联合用药方法，达到提高镇痛效果，有效扩张宫颈并减少手术并发症的目的。 1 资料与方法 1.1 一般资料 选择2002年3月～2004年12月来我院门诊要求终止妊娠的早孕妇女300例，年龄17～30岁，停经42～63天，无麻醉及人工流产禁忌证，术前24h未服用任何药物，均为初次妊娠，随机分为2组，每组150例。各组年龄、体重指数、孕龄等方面均行t检验，P＞0.05，具有可比性。 1.2 方法 试验组：手术前3min予芬太尼以0.001mg/kg剂量，肘前静脉推注后予国产双