利多卡因与芬太尼丙泊酚用于无痛人流临床观察.docVIP

利多卡因与芬太尼丙泊酚用于无痛人流临床观察 　　摘 要 目的：比较两种不同静脉麻醉方法行无痛人工流产术的麻醉效果。方法：择期行无痛人工流产术200例，随机分为芬太尼+丙泊酚组(A组)；利多卡因+芬太尼+丙泊酚组(B组)，每组100例。A组先给予芬太尼0.001～0.002mg/kg(＞0.1mg便于给药按0.1mg给，以下同)；再静注丙泊酚2mg/kg，注药完毕，手术开始。B组先给予芬太尼0.001～0.002mg/kg，再推注利多卡因40mg，接丙泊酚缓慢推注约1.2mg/kg，注药完毕患者入睡后，手术开始。术中手术操作有肢动，给予诱导丙泊酚量1/3～1/2。结果：B组与A组相比，镇痛更满意，双下肢肢体活动影响手术操作无，生命体征相对平稳，诱导推药对局部血管刺激性疼痛无，术中丙泊酚用量明显减少，术毕清醒及离院时间更短(P＜0.01)。结论：利多卡因+芬太尼+丙泊酚用于无痛人工流产术，麻醉效果满意安全。 　　关键词 芬太尼 利多卡因 丙泊酚 无痛人工流产术 　　doi:10.3969/j.issn.1007-614x.2012.07.122 　　Abstract Objective:Comparing two different methods of intravenous anesthesia line painless artificial abortion anesthesia.Methods:Elective surgery 200 cases of induced abortion.Randomly assigned to fentanyl+propofol group(A);lidocaine+fentanyl+propofol group(B).Each group of 100 cases.A group of first fentanyl 0.001～0.002mg/kg(＞0.1mg 0.1mg to facilitate the administration by the same below);then intravenous propofol 2mg/kg,the injection is completed,the beginning of surgery.Group B first fentanyl 0.001～0.002mg/kg,pushed injection of lidocaine 40mg,then slow bolus of propofol of about 1.2mg/kg,the injection is completed the patient,such as sleep after surgery began.Result:Operative limb surgery are moving to give the amount of propofol induction 1/3～1/2.End of surgery.The results in group B compared with group A,pain is more satisfactory,both lower extremities without physical activity affect the surgical operation,a relatively stable vital signs,induction of local vascular irritation to push drugs on pain-free,the amount of intraoperative propofol significantly reduced,surgery awake and less time away from the hospital(P＜0.01).Conclusion:lidocaine+fentanyl+propofol for painless abortion,anesthesia satisfactory security,convenient worth wide range of clinical applications. 　　Key Words fentanyl medication lidocaine propofol induction sequence and method of painless abortion 　　随着丙泊酚等短效静脉全麻药物的应用，门诊在静脉全麻下行短小手术或行检查、治疗越来越普及。2009年以来开展芬太尼+利多卡因+丙泊酚静脉全麻用于无痛人工产术，取得满意效果。现报告如下。 　　资料与方法 　　一般资料：选择200例妊