Application of propofol,fentanyl and remifentanil in cases of painless artificial abortion

Objective To compare the anesthetic effect,anesthesia depth,recovery time,total propofol consumption and its effect on patients′ respiration and circulation of propofol alone,propofol plus fentanyl and propofol plus remifentanil in the process of painless artificial abortion.Methods One hundred and eighty patients for painless artificial abortion were randomly divided into three groups:propofol group,propofol plus fentanyl group and propofol plus remifentanil group,60 patients in each group.The target plasma concentration of propofol in propofol group was 8.0 mg·L-1.In propofol plus fentanyl group,1.0 μg·kg-1 fentaini were injected intravenously before the infusion of propofol,and the target plasma concentration of propofol was set as 5.5 mg·L-1.In propofol plus remifentanil group,1.0 μg·kg-1 remifentanil were injected intravenously before the infusion of propofol,and the target plasma concentration of propofol was also set as 5.5 mg·L-1.Mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),and bispectral index(BIS)at administration of the drugs(T1),during operation(T2) and eyes opening moment(T3) were monitored,and total propofol consumption,induction time,and recovery time were recorded during the operation.Analgesic effect were valued after operation in three groups.Results After administration of the drugs,MAP of all the three groups decreased.During operation(T2),the blood pressure of propofol group decreased obviously compared with that of propofol plus remifentanil group(P0.05),but showed no significant difference compared with that of propofol plus fentanyl group(P0.05).HR of propofol group at eyes opening moment(T3)was obviously faster than those of the other two groups(P0.05).However,HR of propofol plus remifentanil group during operation(T2)was dramatically slower than that of propofol group(P0.05).The SpO2 in all the three groups during the whole operation process showed no statistical differences(P0.05).After drugs administration,BIS value in all the three groups decreased obviously.During operation,BIS value of propofol plus remifentanil group was slightly higher than that of propofol group(P0.05),and showed no statistical differences,compared with that of propofol plus fentanyl group(P0.05).Induction time between propofol plus fentanyl and propofol plus remifentanil groups showed no signaficant difference(P0.05),and were both longer than that of propofol group(P0.05).Awaking time between propofol and propofol plus fentanyl groups showed no significant difference(P0.05),and were both longer than that of propofol plus remifentanil group(P0.05).The total consumption of propofol between propofol plus fentanyl and propofol plus remifentanil group showed no signaficant difference(P0.05),and were both larger than that of propofol group(P0.05).The operation time in all three groups appeared no statistical differences(P0.05).The analgesia effect between propofol plus fentanyl group and propofol plus remifentanil group showed no signaficant difference(P0.05),and were both better than that of propofol group(P0.05).Conclusion In the process of painless artificial abortion,propofol plus fentanyl or remifentanil have obviously advantages on the aspect of analgesia effect and drug consumption compared with propofol alone.In addition,considering of the recovery time propofol plus remifentanil has the most advantage in all the three groups.