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目的探讨不同剂量瑞芬太尼、芬太尼配伍异丙酚用于无痛人流的麻醉效果及安全性.方法选择ASAⅠ~Ⅱ级早期妊娠需要人工流产的早孕妇女120例,随机分成A、B、C、D四组,每组30例,A、B组分别首注芬太尼1.0ug/kg和芬太尼1.4ug/kg,两组首注后均以芬太尼0.1ug?kg-1?min-1泵注维持.C、D 组分别首注瑞芬太尼1.0ug/kg和0.75ug/kg,后均以瑞芬0.1 ug?kg-1?min-1泵注维持.四组首注后均静注异丙酚1mg/kg,观察血压、心率、SPO2、镇痛镇静效果、体动反应、苏醒时间.结果 B、C组体动少,手术效果好.A组术中燥动机率明显多,使用瑞芬太尼的C、D两组均会出现呼吸抑制,且随瑞芬太尼用量的增加呼吸抑制时间明显延长,最长4分钟.结论通过以上观察,个人认为瑞芬太尼配用异丙酚用于无痛人流手术,麻醉效果好,但呼吸抑制发生率较高,需配备齐全复苏抢救设备,增加麻醉及手术人员的紧张感,相反芬太尼1.4ug/kg,配合异丙酚用于无痛人流,呼吸抑制少,效果好,更适用于门诊无痛人流.“,”objective To study Anesthetic effect and safety of different dose of Fentanyl, Remifentanil combined with propofol on painless abortions. Methods Totaly 120 women levels at ASA Ⅰ ~ Ⅱearly pregnancy need artificial abortion,Random divided into A, B, C, D four grous,Each group of 30 cases: A and B groups were first Respectively inject fentanyl 1.0 ug/kg and fentanyl 1.4 ug/kg, after the first injection ,the group A and group B were pumped with fentanyl 0.1 ug?kg-1?min-1 to maintain, C ,D groups were Respectively intravenous remifentanil 1.0ug/kg and 0.75uk/kg, Then maintain with remifentanil 0.1ug?kg-1?min-1 pump ; after the first injection ,A, B, C, D four groups are intravenous injection propofol 1 mg/kg , Observation of blood pressure、 heart rate、SPO2、Sedation and analgesia effect, Body dynamic response Revival time. Result at operation time B and C groups moving less ,operation effect were good .among group A ,The persons with fidgety probability were more then the rest of the three groups. Used with Remifentanil C and D groups both appeared respiratory arrest, And with the increase of the content of remifentanil ,the respiratory depression time was significantly longer ,The longest 4 minutes. Conclusion Through the above observation, I think that Remifentanil with propofol for the stream of people surgery is good at Anesthetic effect,But respiratory inhibition rate is higher, should be equipped with a complete recovery rescue equipment wich Increase the anesthesia and surgery personnel nervousness, on the contrary fentanyl 1.4 ug/kg with propofol for painless abortions, respiratory depression less, the effect is good, more suitable for the clinic painless abortions.