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目的观察安定配伍米索前列醇及利多卡因用于人工流产术中镇痛的临床效果及安全性。方法自愿要求施行麻醉镇痛技术终止早期妊娠的妇女160例,随机分为实验组及对照组各80例。两组术前30 min均口服米索前列醇0.2 mg。实验组术前5 min于宫颈旁行2%利多卡因2 ml注射,手术开始前静脉缓慢注射安定10 mg后行人工流产术。对照组将异丙酚按照2.0 mg/kg缓慢静脉注射,待受术者意识消失即开始手术。观察两组宫颈扩张情况、术中镇痛效果、手术时间、术中出血量、血压和呼吸及血氧饱和度等。结果两组在术中宫颈扩张、出血量、手术时间方面无差异。实验组血压和呼吸及血氧饱和度与术前比较无明显变化,对照组麻醉后收缩压下降、呼吸频率减慢、血氧饱和度略有下降。两组镇痛效果均良好,但实验组疼痛0级的人数比对照组少,疼痛Ⅰ级的人数比对照组多,差异有统计学意义(P<0.05)。结论米索前列醇配伍异丙酚施行的人工流产术,可在有麻醉执业医师条件的机构开展;安定配伍米索前列醇及利多卡因用于人工流产,镇痛效果确切、安全经济,值得推广应用。
Objective To observe the clinical effects and safety of diazepam and misoprostol for analgesia induced by induced abortion. Methods A total of 160 women with early pregnancy terminated by anesthesia and analgesia were randomly assigned to receive 80 cases of experimental and control groups respectively. Both groups were given oral misoprostol 0.2 mg 30 min before operation. In the experimental group, 2 ml of 2% lidocaine was injected into the cervix 5 min before the operation, and 10 mg of venlafaxine was injected slowly before the start of the operation. In the control group, propofol was slowly injected intravenously at a dose of 2.0 mg / kg, and surgery was started until the consciousness of the surgeon disappeared. Observation of two groups of cervical dilatation, intraoperative analgesia, operation time, intraoperative blood loss, blood pressure and breathing and oxygen saturation. Results The two groups had no difference in intraoperative cervical dilatation, bleeding volume and operation time. The blood pressure, respiration and oxygen saturation of the experimental group had no significant changes compared with the preoperative values. The systolic pressure of the control group decreased after anesthesia, the respiratory rate slowed down and the oxygen saturation decreased slightly. The analgesic effect was good in both groups, but the number of pain grade 0 in the experimental group was less than that in the control group. The number of patients with grade Ⅰ pain was more than that in the control group (P <0.05). Conclusion Misoprostol combined with propofol administered by abortion may be carried out in institutions with anesthesia practicing physicians. The combination of misoprostol and lidocaine for induced abortion has definite analgesic effect and is safe and economical. Promote the application.