丙泊酚与依托咪酯无痛人流患者麻醉苏醒后的心理状态与药物安全性比较

摘要

OBJECTIVE:To compare mental state and drug safety of puerperant underwent propofol and etomidate painless abortion after regain of consciousness. METHODS:102 puerperant underwent painless abortion were selected and randomly divided into control group and trial groups with 51 cases in each group. The control group received Propofol injection 2 mg/kg intravenous-ly,and the trial group received Etomidate fat emulsion injection 0.2 mg/kg intravenously. The changes of patient’s mental state were evaluated with Positive and Negative Emotions Scale (PANAS) before anesthesia and after regain of consciousness. The changes of HR,BP,MAP and SpO2 were observed and compared between 2 groups before anesthesia and 1,2,3 and 5 min after anesthesia. The anesthetic effect and ADR were compared between 2 groups. RESULTS:Compared to before anesthesia,positive mood scores of the trial group were increased slightly after regain of consciousness,while that of the control group were increased significantly;there was statistical significance before anesthesia and after regain of consciousness (t=9.023,P0.05). The total effective rate of anesthesia in control group was 80.4%,while that of trial group was 78.4%;there was no statistical signifi-cance between 2 groups (χ2=1.273,P>0.05). The incidence of nausea,vomiting,dizziness and other ADR were similar in 2 groups,but the incidence of fantasy(39.2%)in control group was significantly higher in trial group(11.8%);there was statistical significance between 2 groups(χ2=10.120,P<0.05). CONCLUSIONS:Propofol and etomidate have good stability on the respira-tory and circulatory system,anesthetic effects are correspond to the incidence of ADR. Etomidate has a better safety. But the psy-chological status of patients in the propofol group is preceding than etomidate group.%目的：比较采用丙泊酚或依托咪酯进行无痛人流的患者在麻醉苏醒后的心理状态与药物安全性。方法：选取102例行无痛人流的患者，根据随机数字表分为对照组和试验组，各51例。对照组患者在手术过程中静脉注射丙泊酚注射液2 mg/kg进行麻醉，试验组患者静脉注射依托咪酯脂肪乳注射液0.2 mg/kg进行麻醉。通过正性负性情绪量表（PANAS）评定麻醉前与苏醒后患者心理状态的变化，观察并比较两组患者麻醉前及麻醉后1、2、3、5 min心率（HR）、血压（BP）、平均动脉压（MAP）和血氧饱和度（SpO2）的变化，并比较两组患者的麻醉效果和不良反应。结果：与麻醉前比较，试验组患者苏醒后正性情绪得分升高不明显，对照组患者正性情绪得分显著升高，组内比较差异有统计学意义（t＝9.023，P＜0.05），组间比较差异有统计学意义（t＝8.367，P＜0.05）；苏醒后两组患者负性情绪得分均明显降低，组内比较差异有统计学意义（t＝8.672，9.895，P＜0.05）。两组患者麻醉后5 min内的HR、BP、MAP、SpO2比较差异无统计学意义（P＞0.05）。对照组麻醉总有效率为80.4％，试验组为78.4％，组间比较差异无统计学意义（χ2＝1.273，P＞0.05）。两组患者恶心、呕吐、头昏等不良反应发生率相当，但对照组梦幻率（39.2％）明显高于试验组（11.8％），差异有统计学意义（χ2＝10.120，P＜0.05）。结论：丙泊酚与依托咪酯对患者呼吸和循环系统均具有较好的稳定性，麻醉效果和不良反应发生率相当，但依托咪酯安全性较好，而丙泊酚组患者的心理状态较优。