氟比洛芬或芬太尼复合咪达唑仑配伍丙泊酚用于无痛人工流产的临床观察

摘要

目的观察氟比洛芬、芬太尼复合咪达唑仑与丙泊酚联合用于人工流产术的临床效果及不良反应。方法ASA分级玉级门诊患者90例随机分为观察组A组(氟比洛芬组)、B组(芬太尼组)和对照组C组(丙泊酚组)各30例。监测患者麻醉前2分钟(T0)、睫毛反射消失后(T1)、宫腔吸引(T2)、手术结束(T3)、患者苏醒时(T4)的平均动脉压、心率、氧饱和度(pulse oxygen saturation,SpO2)情况；记录三组患者注射丙泊酚的疼痛反应,记录麻醉效果、丙泊酚总用药量、术后苏醒时间、不良反应发生率以及患者苏醒时(T5),术后10分钟(T6)、术后20分钟(T7)的视觉模拟(visual analog scale,VAS)评分法。结果A、B两组血液动力学平稳(P<0.01)、丙泊酚用量较少(P<0.01)、苏醒时间快(P<0.01)、不良事件率低(P<0.01)。结论氟比洛芬或芬太尼复合咪达唑仑配伍丙泊酚用于无痛人工流产较单纯应用丙泊酚能明显减少丙泊酚的用量,血液动力学更加平稳,苏醒时间更短,而且在患者的舒适性上氟比洛芬要好于芬太尼。%Objective To observe the clinical effects and adverse reactions of flurbiprofen or fentanyl combined with midazolam and propofol for painless artificial abortion. Method 90 patients who were ASA I were randomly divided into three groups :group A ( flurbiprofen) , group B ( fentanyl) and group C( propofol) ,and there were 30 cases in each group. We monitor the patient's MAP, HR, SpO2 2min before anesthesia (T0), after eyelash reflex disap-peared(T1), intrauterine attract (T2), the end of surgery (T3), awake (T4) respectively; And pain response when injecting propofol, anesthesia effects, the total dosage of propofol, postoperative recovery time, incidence of adverse events and VAS scores when patient awake (T5), 10min (T6) and 20min after surgery (T7). Result There was smoothly hemodynamics (P<0. 01), less dosage of propofol (P<0. 01), less recovery time (P<0. 01), low incidence adverse events (P<0. 01). Conclusion The doseage of propofol was less, hemodynamics were more stable, recovery time was shorter on Flurbiprofen or fentanyl combined with midazolam and propofol group compared with simplely propofol group. And flurbiprofen was better than fentanyl on patient's comfort.