丙泊酚联合舒芬太尼/芬太尼对无痛人流患者麻醉效果分析

目的:研究丙泊酚联合舒芬太尼或芬太尼对无痛人流患者麻醉情况及术后疼痛的影响差异。方法:选取我院自愿申请无痛人流孕妇208例,通过随机数表法分为实验组(n=104)和对照组(n=104),对照组给予丙泊酚联合芬太尼用药,实验组给予丙泊酚联合舒芬太尼用药。观察并记录患者麻醉前(T0)、麻醉后手术前(T1)、扩宫时(T2)、术后(T3)的MAP、SpO_2、RR、HR;记录患者丙泊酚用量、苏醒时间、患者醒后宫缩VAS疼痛评分;记录两组患者不良反应的发生率。结果:与T0时比较,两组在T1和T2时的MAP、SpO_2、RR、HR均有所降低,且差异有统计学意义(P0.05),两组间比较无明显差异(p0.05);实验组丙泊酚用量低于对照组(P0.05);实验组的平均苏醒时间、醒后宫缩VAS疼痛评分及丙泊酚注射痛均低于对照组,差异有统计学意义(P0.05)。实验组的恶心呕吐、呼吸抑制等不良反应发生率均较对照组有所降低,但差异无统计学意义(P0.05)。结论:丙泊酚联合舒芬太尼较丙泊酚联合芬太尼镇痛作用更佳,术后恢复更快,值得在无痛人流手术推广使用。

Comparison of the Effect of Anesthesia and Postoperative Pain Relief between Propofol Combined with Sufentanil and Propofol Combined with Fentanyl in Painless Abortion

ABSTRACT Objective: To research the difference of the effects of anesthesia and postoperative pain relief between propofol com- bined with sufentanil and propofol combined with fentanyl in painless abortion. Methods: 208 cases with voluntarily painless abortion were selected in our hospital. They were randomly divided into experimental group (n=104) and control group (n=104). The control group was given propofol combined with fentanyl and the experimental group was given propofol combined with sufentanil intravenous- ly. Recording MAP, SpO₂, RR and HR at the time of premedication(T0), preoperation(T1), expanding cervix uterus(T2) and postopera- tion(T3). Recording the dosage of propofol, recovery time and VAS score of uterine pain after the operation. Adverse reactions were also recorded in both groups of patients. Results: Compared with those at T0, the MAP, SpO2, RR, HR were all statistically decreased at the time of T1 and T2 in both groups (P<0.05), but the difference were not significant between both groups (P>0.05). The dosage of propofol in the experimental group was lower than in the control group(P<0.05). The average recovery time was shorter and the VAS score of uterine pain and propofol injection pain were lower in the experimental group than in the control group(P<0.05). The incidence of nausea and vomiting and respiratory depression were lower in the experimental group than in the control group, but the difference was not statis- tically significant (P>0.05). Conclusion: Propofol combined with sufentanil was more effective than propofol combined with fentanyl, with better postoperative recovery. It is worth promoting application in painless abortion operation.