中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
1期
93-95
,共3页
金学勇%金娜%祁燕%侯倩丽
金學勇%金娜%祁燕%侯倩麗
금학용%금나%기연%후천려
瑞芬太尼%异丙酚%人工流产%静脉全身麻醉%监测下麻醉管理技术
瑞芬太尼%異丙酚%人工流產%靜脈全身痳醉%鑑測下痳醉管理技術
서분태니%이병분%인공유산%정맥전신마취%감측하마취관리기술
Remifentanil%Propofol%Abortion%Intravenous anesthesia%Under monitored anesthesia management techniques
目的 对瑞芬太尼辅助宫旁阻滞监测下麻醉管理技术在门诊无痛人工流产手术中的应用效果.方法 选择要求无痛人工流产手术的患者80例,ASA Ⅰ、Ⅱ级,随机分为异丙酚静脉全身麻醉组(E组,40例)和瑞芬太尼辅助宫旁阻滞监测下麻醉管理技术组(R组,40例).观察患者麻醉用药前、中、后的心率、呼吸频率、平均动脉压(MAP)、血氧饱和度(SpO2)的变化情况.记录两组患者手术时间、呼吸抑制时间、苏醒时间、VAS镇痛评分、离院时间及患者满意度.结果 与用药前比较,两组患者用药后MAP、心率、呼吸频率、SpO2均明显降低(P＜0.05或P＜0.01);麻醉中呼吸频率、SpO2 R组低于E组(P均＜0.05);E组注射疼痛、肢体运动的发生例数多于R组(注射疼痛:11例与0例,P=0.0004;肢体肢体运动:4例与0例,P =0.0402);清醒时间、离院时间E组明显长于R组[清醒时间:(5.01±0.75)min与(0.00 ±0.0)min,t=-42.248,P=0.000;离院时间:(27.78±4.65) min与(18.68±3.80) min,t=-9.584,P=0.000];VAS评分E组优于R组[(0.00±0.0)分与(0.45±0.09)分,t=3.162,P=0.002];两组患者满意度均达100％.结论 在门诊人工流产手术麻醉中,异丙酚静脉全身麻醉与瑞芬太尼辅助宫旁阻滞监测下麻醉管理技术比较,监测下麻醉管理技术镇痛确切、血流动力学平稳、术后恢复快、不良反应少并缩短了离院时间,其效果优于异丙酚静脉全身麻醉,是一种安全有效的麻醉方法.
目的 對瑞芬太尼輔助宮徬阻滯鑑測下痳醉管理技術在門診無痛人工流產手術中的應用效果.方法 選擇要求無痛人工流產手術的患者80例,ASA Ⅰ、Ⅱ級,隨機分為異丙酚靜脈全身痳醉組(E組,40例)和瑞芬太尼輔助宮徬阻滯鑑測下痳醉管理技術組(R組,40例).觀察患者痳醉用藥前、中、後的心率、呼吸頻率、平均動脈壓(MAP)、血氧飽和度(SpO2)的變化情況.記錄兩組患者手術時間、呼吸抑製時間、囌醒時間、VAS鎮痛評分、離院時間及患者滿意度.結果 與用藥前比較,兩組患者用藥後MAP、心率、呼吸頻率、SpO2均明顯降低(P＜0.05或P＜0.01);痳醉中呼吸頻率、SpO2 R組低于E組(P均＜0.05);E組註射疼痛、肢體運動的髮生例數多于R組(註射疼痛:11例與0例,P=0.0004;肢體肢體運動:4例與0例,P =0.0402);清醒時間、離院時間E組明顯長于R組[清醒時間:(5.01±0.75)min與(0.00 ±0.0)min,t=-42.248,P=0.000;離院時間:(27.78±4.65) min與(18.68±3.80) min,t=-9.584,P=0.000];VAS評分E組優于R組[(0.00±0.0)分與(0.45±0.09)分,t=3.162,P=0.002];兩組患者滿意度均達100％.結論 在門診人工流產手術痳醉中,異丙酚靜脈全身痳醉與瑞芬太尼輔助宮徬阻滯鑑測下痳醉管理技術比較,鑑測下痳醉管理技術鎮痛確切、血流動力學平穩、術後恢複快、不良反應少併縮短瞭離院時間,其效果優于異丙酚靜脈全身痳醉,是一種安全有效的痳醉方法.
목적 대서분태니보조궁방조체감측하마취관리기술재문진무통인공유산수술중적응용효과.방법 선택요구무통인공유산수술적환자80례,ASA Ⅰ、Ⅱ급,수궤분위이병분정맥전신마취조(E조,40례)화서분태니보조궁방조체감측하마취관리기술조(R조,40례).관찰환자마취용약전、중、후적심솔、호흡빈솔、평균동맥압(MAP)、혈양포화도(SpO2)적변화정황.기록량조환자수술시간、호흡억제시간、소성시간、VAS진통평분、리원시간급환자만의도.결과 여용약전비교,량조환자용약후MAP、심솔、호흡빈솔、SpO2균명현강저(P＜0.05혹P＜0.01);마취중호흡빈솔、SpO2 R조저우E조(P균＜0.05);E조주사동통、지체운동적발생례수다우R조(주사동통:11례여0례,P=0.0004;지체지체운동:4례여0례,P =0.0402);청성시간、리원시간E조명현장우R조[청성시간:(5.01±0.75)min여(0.00 ±0.0)min,t=-42.248,P=0.000;리원시간:(27.78±4.65) min여(18.68±3.80) min,t=-9.584,P=0.000];VAS평분E조우우R조[(0.00±0.0)분여(0.45±0.09)분,t=3.162,P=0.002];량조환자만의도균체100％.결론 재문진인공유산수술마취중,이병분정맥전신마취여서분태니보조궁방조체감측하마취관리기술비교,감측하마취관리기술진통학절、혈류동역학평은、술후회복쾌、불량반응소병축단료리원시간,기효과우우이병분정맥전신마취,시일충안전유효적마취방법.
Objective To investigate the analgesia effects and adverse effect of the monitored anesthesia care of remifentanil assisted by cervix nerves block and the propofol intravenous general anesthesia on abortion.Methods Eighty patients with ASA Ⅰ-Ⅱ were selected and divided into the group of propofol intravenous general anesthesia (E group,n =40) and the group of the monitored anesthesia care of remifentanil assisted by cervix nerves block (R group,n =40).Heart rate (HR),respiratory rate (RR),mean arterial pressure(MAP),oxygen saturation(SpO2) were recorded before,during and after the operation.Operative time,respiratory depression time,recovery time,VAS score,hospital time and patient satisfaction of the patients in the two groups were recorded.Results The MAP,HR,RR,SpO2 of the patients in the two groups after analgesia were significantly decreased compared with that of before analgesia (P ＜ 0.05 or P ＜ 0.01).The levels of RR,SpO2 in R group after analgesia were obviously lower than that in group E (P ＜ 0.05).The cases number who occurred incidence of injection pain,physical movement in E group were higher than that in R group(injection pain:11 cases vs.0 case,P =0.0004 ; Physical movement:4 cases vs.0 case,P =0.0402).The wake up time and the period of staying in hospital in E group were longer than that of R group(wake up time:(5.01 ±0.75)min vs.(0.00 ± 0.00) min,t =-42.248,P =0.000 ; Time from hospital:(27.78 ± 4.65) min vs.(18.68±3.80) min,t =-9.584,P =0.000).The analgesic effects of VAS in E group was (0.00 ±0.0),better than that of group R ((0.45 ± 0.09),t =3.162,P =0.002).The satisfaction rate in two groups were 100％.Conclusion The method of monitored anesthesia care of remifentanil assisted by cervix nerves block is proved to be better than that of propofol intravenous general anesthesia at induced abortion regarding of precise monitored anesthesia pain management techniques,stable hemodynamics,rapid postoperative recovery,adverse reactions and shorten the time from the hospital,which was better than propofol anesthesia,and is a safe and effective method of anesthesia.
