右美托咪定复合丙泊酚和芬太尼在无痛人流术中应用观察.docVIP

右美托咪定复合丙泊酚和芬太尼在无痛人流术中应用观察 　　摘 要：目的 观察右美托咪定复合丙泊酚和芬太尼在无痛人流术中的应用。方法 选择择期行无痛人流术的患者400例，随机分为丙泊酚和芬太尼组（P组）以及右美托咪定复合丙泊酚和芬太尼组（EP组）。术前2 min给予芬太尼0.5 μg/kg静注，术中丙泊酚以靶控（TCI）模式输注，右美托咪定以恒速模式输注，根据患者镇静深度适当调整注射速度。记录所有患者的药物起效时间、操作时间、苏醒时间以及出室时间，并记录低血压、心动过缓、缺氧和注射痛等不良事件。结果 EP组围术期低血压、心动过缓、缺氧、注射痛发生率较P组显著降低，差异具有统计学意义（P0.05）。结论 右美托咪定复合丙泊酚和芬太尼在无痛人流术中对呼吸、循环系统影响小，注射痛发生率更小，显著提高无痛人工流产术的安全性及舒适性。 　　关键词：右美托咪定；丙泊酚；无痛人流术；镇静；并发症 　　中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.03.047 　　文章编号：1006-1959（2018）03-0134-03 　　Abstract：Objective To observe the application of dexmetomidine combined with propofol and fentanyl in painless abortion.Methods 400 patients undergoing painless abortion were randomly divided into propofol and fentanyl group （P group） and Dexmedetomidine combined with propofol and fentanyl group （group EP）.Preoperative 0.5μg/kgfentanyl intravenous injection2 min before the operation， intraoperative infusionof propofol in target controlled （TCI） mode， dexmedetomidine infusion at a constant speed mode， adjust the injection speed according to the depth of sedation of patients. Drug onset time， operation time， recovery time and ventricular exit time were recorded in all patients. Adverse events such as hypotension， bradycardia， anoxia and injection pain were recorded.Results The incidence of hypotension bradycardia hypoxia and injection pain in EP group was significantly lower than that in P group，the difference was statistically significant（P 0.05）.Conclusion Dexmetomidine combined with propofol and fentanyl has little effect on respiratory and circulatory system and less incidence of injection pain during painless artificial abortion， which can significantly improve the safety and comfort of painless induced abortion. 　　Key words：Dexmedetomidine；Propofol；Painless abortion；Sedation；Complications 　　丙泊酚（propofol）作?橐恢志?典的镇静药物，具有起效快、半衰期短、苏醒迅速、镇静深度完善等优点[1]，既往多采用单纯丙泊酚和芬太尼完成无痛人流术。但丙泊酚镇静有一些缺点，最显著的就是剂量相关性的呼吸抑制与低血压，从而给患者带来安全隐患。右美托咪定在血流动力学方面相较丙泊酚具有一定的优势。它是一种高选择性的α2肾上腺素能受体激动剂，受体选择性（α2∶α1）为1