依托咪酯及丙泊酚合并瑞芬太尼在无痛人工流产中应用比较.docVIP

依托咪酯及丙泊酚合并瑞芬太尼在无痛人工流产中应用比较[摘要] 目的 探讨依托咪酯合并瑞芬太尼用于无痛人工流产的临床实用性,对比其与丙泊酚效果的差别。方法 140例拟行无痛人工流产的病例分成2组,A组以依托咪酯0.2mg/kg+瑞芬太尼1μg/kg和B组以丙泊酚2mg/kg+瑞芬太尼1μg/kg进行麻醉。结果 B组MAP和HR显著下降,除A组中观察到肌阵挛外,两组中未见明显不良反应。结论 依托咪酯-瑞芬太尼可以安全地用于无痛人工流产的麻醉,麻醉效果与丙泊酚-瑞芬太尼相似,具有广泛的临床应用价值。 [关键词] 依托咪酯;瑞芬太尼;丙泊酚;无痛人工流产 [中图分类号] R714.21 [文献标识码] A[文章编号] 1673-9701(2009)34-87-02 Comparison of Etomidate plus Remifentanil with Propofol plus Renm- ifentanil in Painless Artificial Bortion ZHENG MaoCHEN HongWEI Shuangshuang Department of Anesthesia,Mianyang Municipal People’s Hospital,Mianyang 621000,China [Abstract] Objective To explore the clinical value of etomidate combined with remifentanil for painless induced abortion compared with propofol combined with remifentanil. Methods We divided 140 patients,who planned to undergo painless artificial abortion,into two groups: Group A and Group B. Group A was the etomidate plus remifentanil groupand Group B was the propofol plus remifentanil group. Group A was given etomidate(0.2mg/kg) plus remifentanil(1μg/kg) for anesthesia,while Goup B was given propofol(2mg/kg) plus remifentanil(1μg/kg) for anesthesia. Results The MAP and HR were significantly decreased in Group B. Except for myoclonus observed in Group A,there were no side effects in both groups. Conclusion Use of Etomidate plus remifentanil is safe in painless artificial abortion,with its anesthetic effect similar to use of propofol plus renmifentanil,worthy of a wide range of clinical application. [Key words] Etomidate;Remifentanil;Propofol;Painless artificial abortion 丙泊酚和依托咪酯为短效静脉全麻药,均可用于门诊短小手术的麻醉[1],目前无痛人工流产术中主要应用丙泊酚。我们将丙泊酚和依托咪酯分别与瑞芬太尼配伍,目的是为了探讨依托咪酯-瑞芬太尼用于无痛人流技术的临床适用性。 1资料与方法 1.1一般资料 选择ASAⅠ～Ⅱ级自愿要求行无痛人工流产的早孕妇女140例,年龄17～38岁,平均26.9岁。体重42～66kg;妊娠6～9周,既往无心血管及呼吸系统病史和药物过敏史。随机分为两组,各70例,A组为依托咪酯组,B组丙泊酚组。两组年龄、孕次、孕周、体重均无显著性差异。 1.2方法 术前认真询问病史和检查,常规麻醉前准备,严格禁食水6小时。入室后监测MAP、SpO2、HR、ECG,面罩吸氧并建立静脉通道,消毒完成后静脉缓慢推注2%利多卡因2mL,瑞芬太尼1μg/kg,于60s内注射完毕同时嘱患者保持深呼吸,A组静脉推注依托咪酯0.2mg/kg;B组静脉推注丙泊酚2mg/kg;两组静脉推注