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1、內(nèi)泊酚聯(lián)合小劑量布托啡諾用于無痛人工流產(chǎn)的效果觀察作者：祁賓，盧杰，宗，林，張應祥,王玉秀單位：解放軍第82醫(yī)院麻醉科，江蘇淮安【摘要】目的探討丙泊酚聯(lián)合小劑量布托啡諾用于無痛人工流產(chǎn)術(shù)可行性及具與現(xiàn)常用方法相比的優(yōu)缺點。方法160例ASAI級早期妊娠患者隨機分為四紐，每紐40例°A紐(?丙泊酚+芬太尼紐.)靜脈推注芬太尼0.001mg/kg后推注丙泊酚；B組(丙泊酚組)直接靜脈推注丙泊酚;C組、D組(丙泊酚+布托啡諾組)分別推注布托啡諾0.01mg/kg和0.02mg/kg后推注丙泊酚。丙泊酚首劑最為B312.5mg/kg,其余^312mg
2、/kg,術(shù)屮出現(xiàn)肢體扭動者酌情追加丙泊酚30?50mg。觀察比較麻醉前后呼吸循環(huán)變化、麻醉鎮(zhèn)痛效果、術(shù)后恢復情況及不良反應等。結(jié)果四組患者都成功完成于?術(shù)。各紐用藥后均有-?定的循環(huán)抑制，以B紐為著(P<0.05)eA組呼吸抑制發(fā)生率顯著高于其他組(P<0.01)；B組術(shù)中鎮(zhèn)痛不全和術(shù)后腹痛發(fā)生率顯著高于其他各組(P<0.05)；D組蘇BM及離院時間顯著長于A、B、C紐(P<0.01)o縱丙泊酚聯(lián)合小劑量布托啡諾(0.01mg/kg)完全能滿足無痛人工流產(chǎn)術(shù)麻醉需要，并較好地解決單用內(nèi)?泊酚所致鎮(zhèn)痛不全和減少了加用芬太
3、尼引起的呼吸抑制，值得推廣應用于各類門診小于術(shù)和無痛診療技術(shù)。【關(guān)鍵詞】內(nèi)泊酚；布托啡諾；無痛人工流產(chǎn)EffectofpropofolcombinedwithsmalldosesofbutorphanolonpainlessartificialabortionQIBin,LUJie,ZONGLin,ZHANGYingxiang,WANGYuxiu(DepartmentofAnesthesiology,the82thHospitalofPLA,Huaian223001Jiangsu,China)[Abstract]ObjectiveToexpl
4、orethefeasibilityaswellastheadvantagesanddisadvantagesofpropofolcombinedwithsmalldosesofbutorphanolonpainlessabortion.Methods160casesofearlypregnantwomenwithASA(gradeI)wererandomlydividedintofourgroups(40caseseachgroup).PatientsingroupAaccepted0.001mg/kgfentanylfollowedbypr
5、opofolintravenously;PatientsingroupBacceptedintravenouspropofol;PatientsingroupCandDaccepted0.01mg/kgor0.02mg/kgbutorphanolbeforeintravenouspropofolrespectively.TheinitialdoseofpropofolingroupBwas2.5mg/kgand2mg/kginothers,andadditionaldoseswillbeappliedwhenbodymotionoccurre
6、d?Thechangesofrespiratoryandcirculatoryfunction,anesthesiaandanalgesiaeffects,postoperativerecoveryprofileandsideeffectswereobservedbeforeandafteranesthesia.ResultsTheoperationsweresuccessfulinallthepatients?Eachgroupshowedcirculatorydepressiontoacertainextentafteranesthesi
7、a,andthemostonewasgroupB(P<0.05).TheincidenceofrespiratorydepressioningroupAwasthehighest(P<0.01).AndtheincidenceofintraoperativeinsufficientanalgesiaandpostoperativeabdominalpainingroupBwasthemostsignificant(P<0.05).Inaddition,theawaketimeanddeparturetimewasthelon
8、gestingroupD(P<0.05).ConclusionPropofolcombinedwithsmalldosesofbutoiphanol(0.01
