闫四方

【摘 要】目的：探討芬太尼和丙泊酚配伍依托咪脂在无痛人流中的麻醉效果。方法：选取我院2021年6月至10月收治的360例无痛人流患者为研究对象，将受试者以1：1模式进行随机分组，各180例，对照组患者给予芬太尼复合丙泊酚麻醉，研究组患者在对照组的基础上配伍依托咪脂麻醉，对比两组患者不同时刻血流动力学指标变化、手术相关指标、术后镇静评分及不良反应发生率。结果：两组患者在麻醉前、手术开始后1min及手术结束时各血流动力学指标比较无统计学差异（P>0.05） ，但在麻醉后1min研究组患者的MAP、HR及SpO2均显著高于对照组（P<0.05）；研究组患者丙泊酚用量较对照组更少，术后留观时间及麻醉苏醒时间较对照组更短，VAS评分较对照组更低，两组之间相比（P<0.05）；研究组患者在术后5min、10min、15min时的Ramsay评分均显著低于对照组（P<0.05）；研究组患者各类不良反应发生率均显著低于对照组，两组之间相比（P<0.05）。结论：芬太尼和丙泊酚配伍依托咪脂有助于维持血流动力学的稳定，保持呼吸平稳 ，减少丙泊酚用量，术后麻醉恢复快，且不良反应少，在无痛人流术麻醉中具有较高的应用价值。

【关键词】芬太尼；丙泊酚；依托咪脂；无痛人流；丙泊酚用量；不良反应

Anesthetic effect of fentanyl and propofol combined with etomidate in painless induced abortion

YAN Sifang

Dingtao District Maternal and child health and family planning service center， Heze， Shandong 274100， China【Abstract】Objective： To investigate the anesthetic effect of fentanyl and propofol combined with etomidate in painless induced abortion. Methods： 360 patients with painless abortion treated in our hospital from June to October 2021 were selected as the research object. The subjects were randomly divided into 180 cases in 1：1 mode. The patients in the control group were given fentanyl combined with propofol anesthesia， and the patients in the study group were combined with etomidate anesthesia on the basis of the control group. The changes of hemodynamic indexes， operation related indexes， postoperative sedation score and the incidence of adverse reactions were compared between the two groups at different times. Results： There was no significant difference in hemodynamic indexes between the two groups before anesthesia， 1 min after operation and at the end of operation（P>0.05）， but MAP， HR and SpO2 in the study group were significantly higher than those in the control group 1 min after anesthesia（P<0.05）. The dosage of propofol in the study group was less than that in the control group， the postoperative observation time and anesthesia recovery time were shorter， and the VAS score was lower than that in the control group（P<0.05）. Ramsay scores at 5 min， 10 min and 15 min after operation in the study group were significantly lower than those in the control group（P<0.05）. The incidence of various adverse reactions in the study group was significantly lower than that in the control group（P<0.05）. Conclusion： The combination of fentanyl and propofol combined with etomidate is helpful to maintain the stability of hemodynamics， reduce the dosage of propofol， recover quickly and have less adverse reactions. It has high application value in the anesthesia of painless induced abortion.【Key？Words】Fentanyl； Propofol； Etomidate； Painless abortion； the dosage of propofol； Adverse reaction

无痛人流术是指在全身麻醉下实现人工流产，使患者在无意识的状态下进行手术，该种术式具有无痛、耗时短、安全有效、术后麻醉恢复快的优点，是避孕失败或无生育需求妊娠女性的首选终止妊娠方式[1]。本研究选取我院收治的360例无痛人流患者为研究对象，探讨芬太尼和丙泊酚配伍依托咪脂在无痛人流中的麻醉效果，现进行如下报道。……