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Objective To evaluate the effect of three different doses of oxycodone hydrochloride injection on uterine cramping pain and emotion in patients of artificial abortion.Methods Four hundred female patients, aged 17-38 years, BMI 18.5-23.9 kg/m2, falling into ASA physical statusⅠ orⅡ, undergoing elective artificial abortion were randomized into four groups using a random number table:group O1 (oxycodone 0.06 mg/kg), group O2 (oxycodone 0.08 mg/kg), group O3 (oxycodone 0.1 mg/kg), and group F, 100 cases in each.In group O1, group O2 and group O3, oxycodone 0.06, 0.08, 0.1 mg/kg were intravenously injected respectively, while in group F fentanyl1μg/kg was intravenously injected.Then, propofol 2.5 mg/kg was intravenously injected as induced dose.The operation was started when eyelash reflexes disappeared, propofol 0.4 mg/kg was intravenously injected when body movement appeared during the operation.The propofol doses, operation time and recovery time were recorded.HR, MAP, RR before anesthesia (T0), when loss of eyelash reflex (T1), operation (T2) and recovery (T3) were recorded.The uterine cramping pain was assessed with numerical rating scale (NRS) at recovery, 10, 30, 60 min after operation.Patients'satisfaction was recorded after operation.Patients'emotion was assessed with positive and negative affect scale (PANAS) both before and after operation in one hour.Rescue analgesia, nausea and vomiting, dizziness, respiratory depression, pruritus, uroschesis, cognitive dysfunction, sweatiness were recorded.Results The propofol doses and recovery time in groups O2, O3 and F were significantly lower than those in group O1 (P<0.05).The NRS score of uterine cramping pain in groups O1, O2 and O3 were significantly lower than that in group F (P<0.05).Patients'satisfaction in groups O1, O2 and O3 were significantly higher than that in group F (P<0.05).The positive affective score after operation in one hour among the four groups were significantly higher than that before operation (P<0.05), and the negative affective score after operation in one hour among the four groups were significantly lower than that before operation (P<0.05).The positive affective score after operation in one hour in groups O1, O2 and O3 were significantly higher than that in group F (P<0.05), and the rescue analgesia in groups O1, O2 and O3 were significantly lower than that in group F (P<0.05).There were no significant differences among the four groups as to the dizziness, nausea and vomiting.No respiratory depression, pruritus, emergence agitation, cognitive dysfunction, uroschesis and sweatiness were reported.Conclusion Oxycodone 0.08 mg/kg combined with propofol in patients undergoing artificial abortion is effective in preventing uterine cramping pain.Furthermore, the patients'satisfaction and positive affective score can also be improved.
ABSTRACT
Objective To study the influence of preoperative and postoperative concern and love service on the perioperative clinical indexes,re-pregnancy and adverse drug reaction risk in females of painless artificial abortion.Methods Three hundred and sixty female patients receiving painless artificial abortion operation in our hospital from June 2014 to May 2015 were selected and divided into the control group and observation group by using the random number table method,180 cases in each group.The control group was explained the conventional considerations before and after operation,while the observation group was given the concern and love service before and after operation.Results The induction amount,total amount of propofol,intraoperative bleeding volume,operation time and postoperative bleeding days in the observation group were less than those in the control group(P＜0.05).The observation group had more cases of accidental re-pregnancy,while the cases number of repeated abortion once or above was less than that in the control group(P＜0.05).The incidence rates of infection,irregular menstruation and mental disorder in the observation group were lower than those in the control group(P＜0.05).The implementing rate of effective contraception measures in the observation group was higher than that in the control group,while the incidence rates of safety period,ejaculation outside body,emergency contraception and no contraception were lower than those in the control group(P＜0.05).Conclusion Conducting the concern and love service before and after painless artificial abortion is conducive to the smooth operation,and the implementation rate of effective contraception measures is good.
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Objective To compare different dose of remifentanil combined with propofol for painless abortion and approach to an appropriate dose of remifentanil.Methods Ninety pregnant women with ASA 1 were randomly divided into three groups(n=30)before administrating remifetanil,a bolus midazolam 1 mg was injected inminutes later.These two drugs did not stop administration until three minutes before the end of negative suction.MAP,HR,SpO2,BIS,RR,VT,PET CO2 were monitored.The onset,operation and recovery time,sedation score and adverse reaction were recorded.Results Sedation scores were significantly different between group A and C [(3.90±0.97)and(4.90±0.85),t=4.24,P＜0.01].Three cases in group A were found moving.MAP,HR,BIS decreased as compared witll baseline.HR reduced significantly in group C(P＜0.05,P＜0.01).Respiratory movement was lower and shallower.RR,VT decreased compared to preoperative one.PET C02 increased gradually (P＜0.05,P＜0.01).There were two cases of respiratory depressing in group A,four cases in group B and ten cases in group C(five cases apnea more than three minutes).All patients used oxygen mask to maintain SpO2＞95%.Incidence of adverse reactions such as chest titanic,nausea and vomiting,itching were of no difference among three groups(P＞0.05).All patients were satisfied with anesthesia.Conclusion The appropriate infusing dose of remifetory devices such as oxygen mask and monitoring life signs are very important to prevent respiratory depress and bradycardia during operation.
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Objective: To observe the clinical effects of combination of propofol,fentanyl and in surgical abortion. Methods: A total of 184 early-pregnant women were randomly divided into two groups.The women in group Ⅰ received propofol 2.5 mg/kg intravenously(n=92),the women in group Ⅱ received the combination of propofol,fentanyl and atropine intravenously(fentanyl 1 ?g/kg,atropine 0.5 mg,propofol 1 mg/kg)(n=92).To compare the efficacy of those two kinds of anesthesia,many measurements were taken, which included the total dose of propofol applied,induction time,recovery time,self-walking time,operative time,blood loss during the abortion,dilatation of the uterine cervix,blood pressure,heart rate,breathe,pain caused by injection and post-operation uterine contraction. Results: Many differences were found in the group who received the combination of propofol with fentanyl and atropine,when compared to those measurements in the group received propofol only.Significantly less(amount) of propofol was needed.The induction time was significantly shorter.The slowing of heart rate,dropping of blood pressure and reduction of breathing were significantly less.The dilation of the uterine cervix was more complete and took much less time.The pain caused by injection and post-operation contraction was significantly less frequent and less severe. Conclusion: Applying the combination of propofol,fentanyl and atropine has several clinical benefits which include less propofol need,less inhibition to the respiration and cardiovascular system,and less pain caused by injection and post-operation contraction.