CAJ | 학술논문

目的探讨芬太尼复合丙泊酚在无痛取卵中丙泊酚的首次安全剂量。方法40例自愿接受无痛取卵的患者，ASA分级Ⅰ-Ⅱ级，年龄29±6岁，体重54±9公斤，随机分成四组，A,B,C,D四组丙泊酚的首次剂量依次为1mg/kg，1.5mg/kg，2mg/kg，2.5mg/kg；观察血压，心率，呼吸，氧饱和度，体动反应，呼吸暂停（呼吸间隔长于20秒）；清醒时间（拔出穿刺针至患者问取卵多少的时间）；术后疼痛采用VAS评分标准（0分：无痛；1～3分：轻度疼痛：4～6分：中度疼痛：7～10分：重度疼痛）。结果剂量30秒后B,C,D组患者睫毛反射均消失，而A组有8例患者需追加丙泊酚2～3毫升才能满足穿刺要求；在丙泊酚首次剂量下，B,C两组血压，心率变化轻微，B组有1例氧饱和度下降，而C组有四例氧饱和度下降，托下颌面罩吸氧纠正，两组有显著性差异（P▲<0.01）；在四组中，D组4例患者需面罩加压给氧，2例心率减慢，对呼吸循环抑制作用最大，较B,C组明显抑制（P▲▲<0.01）。A,B,C组患者清醒时间无显著性差异（P※>0.05）分别为94±35秒，90±32秒，91±34秒；D组182±42秒，与前三组有显著性差异（P※※<0.01）；VAS评分：四组患者清醒后疼痛评分无显著性差异（P▲▲▲>0.05）。结论丙泊酚首次剂量1.5mg/kg复合芬太尼1 ug / kg,在取卵操作中具有安全，无痛，苏醒快的特点。
목적탐토분태니복합병박분재무통취란중병박분적수차안전제량。방법40례자원접수무통취란적환자，ASA분급Ⅰ-Ⅱ급，년령29±6세，체중54±9공근，수궤분성사조，A,B,C,D사조병박분적수차제량의차위1mg/kg，1.5mg/kg，2mg/kg，2.5mg/kg；관찰혈압，심솔，호흡，양포화도，체동반응，호흡잠정（호흡간격장우20초）；청성시간（발출천자침지환자문취란다소적시간）；술후동통채용VAS평분표준（0분：무통；1～3분：경도동통：4～6분：중도동통：7～10분：중도동통）。결과제량30초후B,C,D조환자첩모반사균소실，이A조유8례환자수추가병박분2～3호승재능만족천자요구；재병박분수차제량하，B,C량조혈압，심솔변화경미，B조유1례양포화도하강，이C조유사례양포화도하강，탁하합면조흡양규정，량조유현저성차이（P▲<0.01）；재사조중，D조4례환자수면조가압급양，2례심솔감만，대호흡순배억제작용최대，교B,C조명현억제（P▲▲<0.01）。A,B,C조환자청성시간무현저성차이（P※>0.05）분별위94±35초，90±32초，91±34초；D조182±42초，여전삼조유현저성차이（P※※<0.01）；VAS평분：사조환자청성후동통평분무현저성차이（P▲▲▲>0.05）。결론병박분수차제량1.5mg/kg복합분태니1 ug / kg,재취란조작중구유안전，무통，소성쾌적특점。
Objective Opproach the fentanyl and propofol in Painless OVA in the first safe dose. Methods Choice 40 cases of the voluntary acceptance of patients with painless OVA,ASA gradeⅠ-Ⅱ, Age of 29±6 years old, body weight of 54±9 kg , were randomly divided into four groupsA,B,C,D with 20 patients each. A, B, C, D four groups give the initial dose of propofol in the following order: 1mg/kg, 1.5mg/kg, 2mg/kg, 2.5mg/kg; The observation of blood pressure, heart rate, respiration, oxygen saturation, dynamic response, apnea ( breathing intervals longer than 20 seconds ); awake time (from pull out the needle to patients asked how long the time ); postoperative pain with VAS standard ( 0:painless; 1~3:mild pain, 4~6 : moderate pain : 7~10: severe pain). The results for the finitial dose of propofol for the B, C, D group of eyelash reflex disappeared after 30 seconds, and 8 cases in group A must add propofol 2~3 ml to satisfy the operation requirements ; In the initial dose of propofol observe,the B and the C ,both the blood pressure and heart rate changes were mild,just 1 cases in group B oxygen saturation falls, but four cases in group C ,the oxygen saturation decend, under the care of lift the chin,give the oxygen face mask to inhaling of oxygen , there was significant difference (P▲<0.01 ); in the four group, 4 cases in group D patients should face mask pressurized oxygen, 2 cases of heart rate slows,was the greatest inhibition effect on respiration and circulation, compared with B, C group was significantly inhibited (P▲▲<0.01). A, B, C group patients awake time had no significant difference (P※>0.05) was 94 ±35 sec, 90 ±32 sec, 91 ±34 seconds; group D, 182±42 seconds , and compared with A,B,C,there was significant difference (P※※<0.01); VAS score: four groups of patients after awake,the pain score significantly difference (P▲▲▲>0.05 ).Conclusion the initial dose of propofol 1.5mg/kg combined with fentanyl 1 ug / kg, on OVA is safe, painless,revive quick.