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目的观察凯纷(通用名:氟比洛芬酯)术前静脉注射对无痛人工流产术中麻醉及术后宫缩痛的影响。方法按随机数字表法将200例ASAⅠ～Ⅱ级行无痛人工流产术的孕妇,分成实验组(A组)和对照组(B组)各100例。2组年龄、体重、妊娠时间、有无人工流产史等具有可比性。A组预先给予凯纷,B组给予安慰剂(脂肪乳)。2组均用芬太尼复合丙泊酚静脉麻醉,观察2组麻醉诱导前、意识消失时、扩宫结束时、苏醒时的心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO2),记录丙泊酚用量、苏醒时间、不良反应、术后5min及30min宫缩痛情况。结果 2组孕妇在给药后均出现MAP、HR下降(P均<0.05),苏醒后慢慢恢复至麻醉诱导前;在意识消失时及扩宫结束时,A组MAP波动幅度明显低于B组(P<0.05);SpO2在各时间点差异无统计学意义;术中丙泊酚用量A组少于B组(P<0.05);体动发生率A组低于B组(P<0.05);在孕妇苏醒30min时,A组宫缩痛发生率明显低于B组(P<0.01);苏醒时间、呼吸抑制、术后头痛、恶心呕吐差异无统计学意义(P均>0.05)。结论凯纷用于无痛人工流产术,可增强麻醉效果,减少丙泊酚用量,降低术后宫缩痛的发生率。
Objective To observe the effect of preoperative intravenous injection of triptolide (common name: flurbiprofen axetil) on anesthesia and postoperative uterine pain during painless artificial abortion. Methods According to random number table, 200 pregnant women with ASA Ⅰ ~ Ⅱ grade painless induced abortion were divided into experimental group (A group) and control group (B group) with 100 cases each. 2 groups of age, weight, pregnancy time, with or without abortion and other comparable. Group A was given in advance, while Group B was given placebo (fat emulsion). Both groups were anesthetized with fentanyl and propofol. The changes of heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation SpO2), recording the amount of propofol, recovery time, adverse reactions, 5min and 30min after uterine contractions. Results The MAP and HR of the two groups of pregnant women were decreased (all P <0.05), and recovered slowly before anesthesia induction. When the consciousness disappeared and the end of dilation, the amplitude of MAP in group A was significantly lower than that of group B (P <0.05). There was no significant difference in SpO2 between the two groups at any time point. The dosage of propofol in group A was less than that in group B (P <0.05), and the incidence of body movement in group A was lower than that in group B (P <0.05) ); The incidence of uterine contractions in group A was significantly lower than that in group B (P <0.01) at 30min after pregnant women awake. There was no significant difference in recovery time, respiratory depression, postoperative headache and nausea and vomiting (P> 0.05). Conclusions Triumph for painless artificial abortion, can enhance the anesthetic effect, reduce the dosage of propofol and reduce the incidence of postoperative uterinegia.