Effections Of Low-dose Nalmephen Application To Propofol Plus Fentanyl Anesthetic Abortion

Objective To oberve the anesthetic effects and the side effects of low-dose nalmephen in the anesthesia of propofol combined with fentanyl.Methods Radomly,we devided 100 patients who receive general anesthetic abortion into group A and group B(50 each).All the patients retain spontaneous breathing during the selective operation.Group B receive nalmephen(0.25μg/kg)2min prior to anesthesia induction.Both group A and group B receive fentanyl(1.5μg/kg)and atropine 0.01mg/kg for anesthesia.One minute after fentanyl and atropine injection propofol was given(at speed 5mg/s)to both group A and group B,until the vanishing of eyelash reflex.Operations began after the vanishing of eyelash reflex.Same anesthesia management and intraoperative medicine were given to group A and B.The operation time of the tow groups were recorded.SBP,DBP,HR,RR,Sp O2 of group A and B were observed at T0(the time before drug injection),T1(eyelash reflex vanished),T2(the insertion of vaginal speculum),T3(withdrawal of vaginal speculum),T4(recovery from anesthesia).The number of patients who showed cough,body movement,respiratory depression,demand of jaw-lift and mask oxygen inhalation,postoperative nausea and vomiting,intraoperative awareness were recorded.The time point of consciousness disappearance,opening eyes,orientation recovery were recorded.Steward score were evaluated at the moment of opening eyes and orientation recovery.Visual analogue score were measured at the moment of orientation recovery.Results Two groups of patients did not receive ephedrine,astropine during operation.There was no intraoperative awareness the tow groups.There was no statistical differences in operation time,propofol consumption,body movement,time for conscious disappearance,Steward score and visual analog score at the moment of orientation recovery and pain score between group A and B(P>0.05).At all the four time points(T0,T1,T2,T3,T4),there was no differences in SBP,DBP,HR and RR between group A and B(P>0.05).There was no difference in Sp O2 between the tow groups at T0 and T4(P>0.05).Compared with group A,group B had lower rate of cough,respiratory depression,jaw-lifting,mask oxygen inhalation and postoperative nausea and vomiting(P<0.05).The time for eye opening and orientation recovery in group B were shorter than group A at the all four time points.Group B had higher Steward score at the moment of opening eye than group A.Compared with group A,group B had higher Sp O2 at T1,T2,T3(P<0.05).Conclusion Pretreatment of low-dose nalmephen in propofol plus fentanyl anesthetic abortion can reduce the cough,respiratory depression,short the time for anesthesia recovery,improve the quality of anesthesia recovery and improve security and comfort in spontaneously-breathing general anesthesia.