丙泊酚芬太尼在输卵管结扎术中应用体会.docVIP

丙泊酚芬太尼在输卵管结扎术中应用体会 　　作者单位：235162 安徽省宿州市皖北煤电集团总医院刘桥矿医院 　　通讯作者：吴云 　　【摘要】 目的 探讨丙泊酚、芬太尼麻醉行输卵管结扎术的临床应用镇痛效果。方法 将99例受术者随机分成为丙泊酚组57例,局部麻醉组42例。局部麻醉组常规局麻经下腹行输卵管结扎术。丙泊酚组在局部浸润麻醉的基础上，切开皮肤前给予静脉注射丙泊酚注射液1.8 mg/kg，芬太尼注射液0.001 mg/kg，切开腹膜进入腹腔前，再用微量静脉注射泵给予丙泊酚注射液0.2mg/（kg?min）的速度持续至手术结束时停药。观察两组受术者的术中镇痛效果、血压、心率、血氧饱和度和呼吸频率变化、药物不良反应、手术时间、苏醒和定向力恢复时间。结果 局部麻醉组42例，Ⅱ级9例（21.4%），Ⅲ级28例（66.7%），Ⅳ级5例（11.9%），丙泊酚组57例术中无痛感达100%,手术时间明显缩短,无明显副作用。结论 静脉注射丙泊酚、芬太尼镇痛麻醉加局麻行输卵管结扎术安全、效果可靠，无明显呼吸及循环系统抑制作用。 　　【关键词】 输卵管结扎术； 局部麻醉； 异丙酚、芬尼太麻醉； 镇痛 　　Propofol, fentanyl, tubal ligation in the experience in the application WU Yun.Wanbei Coal Mine Group, General Hospital Liuqiao， Suzhou 235162，China 　　【Abstract】 Objective Of propofol, fentanyl anesthesia clinical application of tubal ligation analgesia.Methods 99 cases by patients who were randomly divided into 57 patients in the propofol group, 42 patients under local anesthesia. General anesthesia local anesthesia group lines by abdominal tubal ligation. Propofol group on the basis of local anesthesia, skin incision and before intravenous injection of propofol 1.8 mg/kg, fentanyl injection 0.001 mg/kg, peritoneum into the abdominal cavity before the incision, and then trace vein injection pump injection of propofol given 0.2mg/（kg?min） rate of withdrawal continue until the end of surgery. Were observed by the surgeons analgesic effect, blood pressure, heart rate, oxygen saturation and respiratory rate changes, adverse drug reactions, surgery time, recovery time of awakening and orientation.Results Of local anesthesia group, 42 cases, Ⅱ 9 cases （21.4%）, Ⅲ grade 28 cases （66.7%）, Ⅳ 5 cases （11.9%）, propofol group 57 patients surgery was 100% pain-free operation time significantly reduced, no obvious side effects.Conclusion Intravenous injection of propofol, fentanyl anesthesia plus local anesthesia line tubal ligation safe, effective and reliable, no significant inhibition of respiratory and circulatory systems. 　　【Key words】 Tubal ligation; Local anesthesia; Propofo