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目的比较七氟烷联合舒芬太尼以及异丙酚2种麻醉方案在无痛人工流产(以下简称人流)术中的效果。方法将100名早期妊娠、自愿无痛人流患者随机分为两组:异丙酚组和七氟烷联合舒芬太尼组,观察两组患者术前、术后血压、心率、血氧饱和度、镇痛效果及不良反应等的发生情况。结果两组患者年龄、体重、平均孕周无明显差异。两组术前血压、心率及血氧饱和度无差异,但术后异丙酚组收缩压和舒张压均下降,收缩压由术前的115.8 mm Hg降至术后的93.0 mm Hg,t=9.826,P=0.000;舒张压由71.6 mm Hg降至63.2 mm Hg,t=4.268,P=0.000;七氟烷联合舒芬太尼组血压变化无差异。七氟烷联合舒芬太尼组清醒时及术后1 h镇痛效果优于异丙酚组,视觉模拟疼痛评分(VAS)得分清醒时为2.0±0.7,术后1 h为3.1±0.6,均低于异丙酚组;术中体动及术后宫缩痛的发生率低于异丙酚组,分别为22.0%和28.0%。但麻醉起效、定向力恢复时间较异丙酚组延长,苏醒期躁动的发生率高于异丙酚组。结论七氟烷联合舒芬太尼的麻醉方案较异丙酚更适合无痛人流的手术要求,并能缓解无痛人流术后的不适。
Objective To compare the effects of sevoflurane combined with sufentanil and propofol anesthesia on painless abortion (hereinafter referred to as abortion). Methods One hundred patients with early pregnancy and voluntary painless flow were randomly divided into two groups: propofol group and sevoflurane combined with sufentanil group. Preoperative and postoperative blood pressure, heart rate, blood oxygen saturation , Analgesic effect and adverse reactions such as the occurrence of. Results There was no significant difference in age, weight and average gestational age between the two groups. Preoperative blood pressure, heart rate and oxygen saturation were not different between the two groups. However, the systolic and diastolic blood pressure of the propofol group decreased after surgery, and systolic blood pressure decreased from 115.8 mm Hg before surgery to 93.0 mm Hg postoperatively, t = 9.826, P = 0.000. Diastolic blood pressure decreased from 71.6 mm Hg to 63.2 mm Hg, t = 4.268, P = 0.000. There was no difference in blood pressure between sevoflurane and sufentanil group. Sevoflurane combined with sufentanil group was superior to propofol group in awake and postoperative 1 hour, the visual acuity pain score (VAS) was 2.0 ± 0.7 when awake, 3.1 ± 0.6 at 1 h after operation, Were lower than those in propofol group. The incidence of body movement and postoperative uterine contraction were lower than those in propofol group (22.0% and 28.0%, respectively). However, the onset of anesthesia, the recovery time of directional force was longer than that of propofol group, and the incidence of restlessness was higher than that of propofol group. Conclusion The sevoflurane combined with sufentanil anesthesia program is more suitable than propofol for painless surgical requirements, and can ease the discomfort after painless abortion.