羟考酮联合依托咪酯在无痛人流术中的应用

目的:探讨不同剂量羟考酮联合依托咪酯在无痛人流术中的应用效果.方法:选择拟行无痛人流术的早孕者120例,随机分为芬太尼组和羟考酮低、中、高剂量组,各30例.芬太尼组和羟考酮低、中、高剂量组分别缓慢静脉注射芬太尼1.0μg/kg和羟考酮0.05、0.1、0.15 mg/kg,5 min后静脉注射依托咪酯0.3 mg/kg,待受试者睫毛反射消失后进行手术.比较各组药物有效性和安全性.结果:各组睫毛反射消失时间、呼之睁眼时间和完全清醒时间差异均无统计学意义(P>0.05);芬太尼组和羟考酮中、高剂量组依托咪酯追加次数均明显少于羟考酮低剂量组(P<0.01).给予依托咪酯前至完全清醒各时点,4组受试者血压、心率、呼吸频率和脉搏氧饱和度间差异均无统计学意义(P>0.05).羟考酮中、高剂量组完全苏醒即刻及苏醒后30 min、2 h的宫缩痛评分均明显低于羟考酮低剂量组(P<0.01);羟考酮高剂量组完全苏醒即刻及羟考酮中、高剂量组苏醒后30 min、2 h的宫缩痛评分均低于芬太尼组(P<0.05～P<0.01).4组发生头晕、呼吸抑制、恶心和呕吐例数差异均无统计学意义(P>0.05);羟考酮中、高剂量组肌阵挛发生例数均少于芬太尼组和羟考酮低剂量组(P<0.05～P<0.01).结论:0.1 mg/kg羟考酮联合依托咪酯在无痛人流术中应用效果较好,且具有可减轻宫缩痛、减少肌阵挛发生的优点.

Application effect of the oxycodone combined with etomidate in painless artificial abortion

Objective:To explore the effects of different doses of oxycodone combined with etomidate in the application of painless artificial abortion. Methods:One hundred and twenty early pregnancy patients scheduled by painless artificial abortion were randomly divided into the fentanyl group,low,medium and high dose of oxycodone groups(30 cases each group). The fentanyl group,low,medium and high dose of oxycodone groups were treated with 1. 0 μg/kg fentanyl,and 0. 05,0. 1 and 0. 15 mg/kg oxycodone by intravenous injection,respectively. All cases were treated with 0. 3 mg/kg etomidate by intravenous injection after 5 min,and operated after the disappearance of eyelash reflex. The efficacy and safety between four groups were compared. Results:The differences of the time of eyelash reflex disappearing, open the eyes after calling and wide-awake between four groups were not statistically significant ( P >0. 05). The number of the cases treated with additional etomidate in fentanyl group,medium and high dose of oxycodone groups were significantly less than that in low dose of oxycodone group(P<0. 01). During etomidate treatment to wide-awake,the differences of blood pressure,heart rate,respiration rate and pulse oxygen saturation between four groups were not statistically significant(P>0. 05). The scores of uterine contraction pain in medium and high dose of oxycodone groups at wide-awake and after 30 min and 2 h of awake were significantly lower than that in low dose of oxycodone group(P<0. 01),and the scores of uterine contraction pain in high dose of oxycodone group at wide-awake,and in medium and high dose of oxycodone groups after 30 min and 2 h of awake were significantly lower than that in fentanyl group(P <0. 05 to P <0. 01). The differences of the number of the cases with dizziness,respiratory depression,nausea and vomiting between four groups were not statistically significant(P >0. 05),and the number of the cases with myoclonus in medium and high dose of oxycodone groups were significantly less than that in fentanyl group and low dose of oxycodone group(P<0. 05 to P<0. 01). Conclusions:The effect of 0. 1 mg/kg oxycodone combined with etomidate in the application of painless artificial abortion is better,which can reduce the uterine contraction pain and myoclonus.