首页|人工流产手术不同剂量利多卡因复合丙泊酚静脉麻醉镇痛效果及对术后恢复影响

人工流产手术不同剂量利多卡因复合丙泊酚静脉麻醉镇痛效果及对术后恢复影响

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目的:探究不同浓度利多卡因复合丙泊酚麻醉对人工流产手术者镇痛效果及安全性.方法:从本院2021年1月-2023年1月拟行人工流产者筛选100例,数字表法随机分为高浓度组、低浓度组各50例,分别采用丙泊酚复合2%或1%利多卡因宫颈旁阻滞麻醉,对比两组麻醉效果、疼痛评分(VAS)、血流动力学、炎症因子与不良反应发生率.结果:低浓度组意识清醒时间(4.7±0.8 min)、定向力恢复时间(6.1±0.6 min)均短于高浓度组(9.1±0.6 min、10.6± 1.0 min),手术时间(12.4±0.4 min)、丙泊酚用量(106.6±3.4 mg)高于高浓度组(10.2±0.6 min、97.9±1.3 mg)、;两组清醒时平均动脉压(MAP)、心率(HR)水平均升高,但高浓度组(80.3±1.5 mmHg、82.8±1.2次/min)低于低浓度组(84.7±1.7 mmHg、86.3±0.8次/min);两组术后30min的VAS评分均降低且高浓度组(1.80±0.81分)低于低浓度组(5.02±0.89分),两组清醒时MAP、HR水平较麻醉前均升高且高浓度组低于低浓度组,术后10min两组TNF-a、IL-6水平较麻醉前升高,但高浓度组(34.35±3.11 pg/ml、24.93±2.65 pg/ml)低于低浓度组(50.25±2.95 pg/ml、50.50±2.74 pg/ml)(均P<0.05).不良反应发生率高浓度组与低浓度组(26.0%、12.0%)无差异(P>0.05).结论:2%利多卡因复合丙泊酚麻醉可提升人工流产镇痛效果,缩减手术时间与丙泊酚用量,减少手术麻醉对血流动力学、炎症反应的影响;1%利多卡因有助于促进意识恢复与定向力恢复,发生呼吸抑制、恶心呕吐、头晕等例数更少,有更高的安全性.
Analgesia effect of the different dosages of lidocaine combined with propofol for the intravenous anesthesia during induced abortion and its influence on the postoperative recovery of women
Objective:To explore the effect and safety of the different dosages of lidocaine combined with propofol for the intravenous anesthesia during induced abortion of women.Methods:100 women who planned to undergo induced a-bortion were selected as research objects from January 2021 to January 2023.According to the numerical table method,these women were randomly divided into two groups(50 cases in each group).The women in group A were given propofol combined with 2%lidocaine for intravenous anesthesia during abortion and the women in group B were given propofol combined with 1%lidocaine for intravenous anesthesia.The anesthetic effect,the pain score of VAS,the he-modynamics,the inflammatory factors levels and the incidence of the adverse reactions of the women were compared between the two groups.Results:The time of the conscious recovery(4.7±0.8 min)and the time of the orientation re-covery(6.1±0.6 min)of the women in group B were significantly shorter than those(9.1±0.6 min and 10.6±1.0 min)of the women in group A.The operation time(12.4±0.4 min)and the dosage of propofol(106.6±3.4 mg)of the women in group B were significantly higher than those(10.2±0.6 min and 97.9±1.3 mg)of the women in group A(P<0.05).The values of the mean arterial pressure(MAP)and heart rate(HR)during waking of the women in the two groups had increased significantly,but which(80.3±1.5 mmHg and 82.8±1.2 beats/min)of the women in group A were significantly lower than those(84.7±1.7 mmHg and 86.3±0.8 beats/min)of the women in group B.The VAS scores of the women in the two groups at 30min after abortion had decreased significantly,and the MAP and HR val-ues of the women in of the two groups at 30min after abortion were significantly higher than those before anesthesia.The MAP and HR values of the women in group A were significantly lower than those of the women in group B.The TNF-aand IL-6 levels of the women in the two groups at 10min after abortion had increased significantly,and which(34.35±3.11 pg/ml and 24.93±2.65 pg/ml)of the women in group A were significantly lower than those(50.25± 2.95 pg/ml and 50.50±2.74 pg/ml)of the women in group B(all P<0.05).There was no significant difference in the incidence of the adverse reactions(26.0%vs.12.0%)of the women between the two groups(P>0.05).Conclusion:2%lidocaine combined with propofol for the intravenous anesthesia during induced abortion of the women can improve their analgesic effect,and which can help to shorten the operation time and increase the amount of propofol uased of the women,reduce the influence of the surgical anesthesia on the hemodynamics and inflammation of the women.1%lidocaine combined with propofol for the intravenous anesthesia during induced abortion of the women can help to pro-mote their recovery of consciousness and orientation,and the incidences of respiratory depression,nausea and vomi-ting,dizziness and other side effect of the women are less,with the higher safety.

Painless induced abortionDifferent dosages of lidocainePropofolPainInflammatory factorPostoper-ative recoveryAdverse reaction

陆惠冰、刘林

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浙江省嘉兴市秀洲区妇幼保健院(314031)

无痛人工流产手术 不同剂量利多卡因 丙泊酚 疼痛 炎症因子 术后恢复 不良反应

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(4)
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