七氟醚吸入麻醉用于无痛人工流产术临床研究.docVIP

七氟醚吸入麻醉用于无痛人工流产术临床研究 　　摘 要 目的:观察研究七氟醚吸入麻醉用于无痛人流手术的麻醉效果及安全性。方法:选择门诊无痛人工流产手术病人40例,随机分为七氟醚吸入麻醉组(S组)和异丙酚静脉麻醉组(P组),每组20例。监测并记录术前、术中、术后的SBP、DBP、HR、SPO?2、麻醉诱导时间、苏醒时间、定向力恢复时间、及不良反应发生情况。结果:P组术中SBP、DBP、HR较术前明显下降,差异有统计学意义(?P?0?05),两组各项不良反应比较无显著差异(?P?0?05)。结论:异丙酚静脉麻醉诱导起效更快,苏醒时间更短,而七氟醚吸入麻醉诱导对血压、心率的影响更小,麻醉更平稳。 　　关键词 七氟醚 异丙酚 无痛人工流产手术 　　doi:10.3969/j.issn.1007-614x.2010.13.121? 　　AbstractObjective:To observe the effects and safety of sevoflurane inhalation anesthesia in painless artificial abortion surgery.Methods:Fourty patients scheduled for painless artificial abortion surgery were randomly divided into sevoflurane inhalation anesthesia group(group S,?n?=20) and propofol intravenous anesthesia group(group P,?n?=20).The two groups received either sevoflurane inhalation anesthesia or propofol intravenous anesthesia.BP,HR,SpO?2before,during and after the surgery,the induction time,palinesthesia time and orientation force recovery time were recorded,at the same time recored the side effects in two groups.Results:In group P,SBP,DBP,HR during the surgery reduced significantly than before the surgery(?P?0?05).Conclusion:The induction time and palinesthesia time of propofol intravenous anesthesiawere shorer than those of sevoflurane inhalation anesthesia,but sevoflurane inhalation anesthesia have little effects on BP and HR,it is profit for stabilization of cardiovascular system. 　　Key wordsSevoflurane;Propofol;Painless artificial abortion? 　　目前门诊人工流产术常采用丙泊酚/芬太尼静脉麻醉,丙泊酚注射时的疼痛刺激给患者造成不适。七氟醚是一种新型的吸入麻醉药,具有无刺激性气味、对呼吸循环抑制轻以及诱导快、苏醒迅速等特点,适用于门诊短小手术。本研究对七氟醚和丙泊酚用于人工流产术的临床麻醉效果进行观察比较,探讨七氟醚用于人工流产术的有效性和安全性。 　　资料与方法 　　选择我院2009年1～12月拟行人工流产术(负压吸引)的早孕妇女40例,年龄16～40岁,体重42～70kg,ASAⅠ级。近期无呼吸道感染史,无药物过敏史。随机分为七氟醚吸入麻醉组(S组)和丙泊酚静脉麻醉组(P组),每组20例,手术时间2～5分钟。 　　麻醉方法:术前禁食、禁饮8小时,入室后开放上肢静脉,常规监测收缩压(SBP)、舒张压(DBP)、心率(HR)和脉搏血氧饱和度(SPO?2),两组均在手术开始前5分钟静注盐酸戊已奎醚1mg、芬太尼0.05mg。麻醉诱导前先给氧去氮3分钟,使SPO?2达98%以上。P组:丙泊酚2mg/kg静注,1分钟内注完,再以6mg/(kg#8226;小时)维持至手术结束,若术中发生体动则快速静注丙泊酚,每次20mg。S组:紧扣面罩,吸入氧流量5L/分钟,调节七氟醚浓度为7%,意识消失后,改用2%～3%七氟醚和2～3ml