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目的:观察改良丙泊酚方案用于高原地区窦性心动过缓患者无痛人工流产的麻醉效果。方法:选择高原地区妊娠合并窦性心动过缓93例,分为观察组54例和对照组39例。对照组给予常规丙泊酚联合利多卡因方案麻醉,观察组给予改良丙泊酚方案(丙泊酚+阿托品复合液)麻醉,比较两组麻醉相关并发症发生情况、手术情况及流产结局。结果:观察组麻醉相关并发症发生率5.6%,无一例出现血压下降和呼吸抑制;对照组为69.2%,心率降至40/min以下并出现血压下降和呼吸抑制5例;观察组麻醉相关并发症发生率非常显著低于对照组(P<0.01)。两组术中出现肢体活动、丙泊酚用量、手术时间和术中出血量比较,均差异不显著(P>0.05)。观察组完全流产51例,不全流产3例,总流产率100.0%;对照组完全流产36例,不全流产3例,总流产率100.0%;两组比较,差异不显著(P>0.05)。结论:改良丙泊酚方案用于高原妊娠合并窦性心动过缓患者无痛人工流产,麻醉效果满意,且安全。
OBJECTIVE: To observe the anesthetic effect of modified propofol regimen for painless induced abortion in patients with sinus bradycardia at high altitude. Methods: Ninety-three cases of pregnancy with sinus bradycardia in the plateau area were selected and divided into observation group (54 cases) and control group (39 cases). The control group was given conventional propofol combined with lidocaine anesthesia. The observation group was given propofol propofol (propofol + atropine compound anesthesia) anesthesia. The incidence of anesthesia-related complications, operation and abortion outcome were compared between the two groups. Results: The incidence of anesthesia-related complication in the observation group was 5.6%. No blood pressure was decreased and respiratory depression was observed in the observation group. The control group was 69.2%, the heart rate dropped below 40 / min and the blood pressure was decreased and respiratory depression occurred. The incidence of disease was significantly lower than that of the control group (P <0.01). There was no significant difference in physical activity, propofol dosage, operation time and intraoperative blood loss between the two groups (P> 0.05). 51 cases of complete abortion in observation group, 3 cases of incomplete abortion, total miscarriage rate of 100.0%; 36 cases of complete abortion in control group, 3 cases of incomplete abortion, the total abortion rate was 100.0%. There was no significant difference between the two groups (P> 0.05). Conclusion: The modified propofol regimen is suitable for painless induced abortion in patients with plateau pregnancy and sinus bradycardia. The anesthetic effect is satisfactory and safe.