舒芬太尼联合丙泊酚用于无痛人工流产对患者意识及人身安全的影响

摘要

目的：探讨舒芬太尼联合丙泊酚用于无痛人工流产对患者意识及人身安全的影响。方法将138例拟行无痛人工流产手术患者按照随机数字表法随机分为对照组和观察组，各69例。对照组给予丙泊酚，观察组在对照组基础上联合舒芬太尼。结果观察组镇痛显效率显著高于对照组（ P﹤0.05）；丙泊酚用量显著少于对照组（ P﹤0.05）；苏醒后30 min宫缩痛视觉模拟评分（VAS评分）显著低于对照组（ P﹤0.05）；两组患者用药后心率( HR )、呼吸频率( RR )、平均动脉压( MAP )较用药前显著降低（ P﹤0.05）；患者苏醒后HR、RR、脉搏血氧饱和度( SpO2)、MAP与用药前比较无统计学差异（ P﹥0.05）；观察组意识恢复时间和定向力恢复时间明显短于对照组（ P﹤0.05）。结论舒芬太尼联合丙泊酚用于无痛人工流产术的临床效果显著，可明显降低术后宫缩痛。患者意识虽很快清醒，但在一定时间内运动协调性、精神兴奋性以及记忆力仍未能恢复至术前水平，且同时存在一定的定向力障碍与疲劳感，故应按照患者对药物的反应差异决定留院观察时间，确保患者的人身安全。%Objective To explore the clinical effect of sufentanil combined with propofol in painless artificial abortion and its influence on patient consciousness and safety. Methods 138 cases undergoing painless artificial abortion were randomly assigned to the control group ( n=69 ) and the observation group ( n=69 ) according to the random number table. The control group received fentanyl combined with propofol, while the observation group was given sufentanil combined with propofol. Results The significantly effective rate in the observa-tion group was significantly higher than that in the control group with statistically significant difference ( P﹤0. 05 );the propofol dosage of the observation group was significant less than that in the control group ( P﹤0. 05 ) . The visual analogue scale ( VAS ) score of contraction pain at 30 min after awakening was significantly lower than that in the control group( P﹤0. 05);HR, RR and MAP after medication in the two groups were significantly decreased compared with before medication( P﹤0. 05);HR, RR, SpO2 and MAP after awakening in the two groups had no statistical differences compared with before medication ( P﹥0. 05 );the awareness recovery time and the orientation recovery time in the observation group were significantly shorter than those in the control group( P﹤0. 05). Conclusion Sufentanil combined with propofol for painless artificial abortion has obviously clinical effect, apparently reduces the postoperative contraction pain. Although the pa-tient ' s awareness is rapidly recovered, but the motor coordination and memory do not still recover to the preoperative levels, moreover cer-tain disorientation and the feeling of fatigue simultaneously exist. Therefore, the time for remaining in hospital under observation should be determined according to the difference of the patient ' s reaction to drugs for ensuring the personal safety of patient.