Comparison Of Anesthetic Effects And Satisfaction Of Propofol Combined With Different Opioids In The Painless Artificial Abortion Operation

Objective:The present study was aimed to compare the anesthetic effect and satisfaction of propofol, propofol combined with fentanyl, propofol combined with remifentanil, and propofol combined with sufentanil in the painless artificial abortion operation. The study tried to find a safe and efficient anesthetic method to meet the needs of painless surgery, provide the basis for clinical studies.Methods:Early pregnant women who voluntarily terminate the pregnancy with the painless anesthetic way and consent to participate into the clinical trial were recruited into in the Fourth Changsha hospital and Hunan Provincial Policy Hospital The patients diagnosed with early intrauterine pregnancy (42-68d), ASA Ⅰ-Ⅱ class, aged17-35years old, body weight43-60kg, no abnormal clotting time, no obvious abnormal electrocardiogram, no history of drug allergy and pulmonary dysfunction were selected into the clinical trial. Four hundred cases were randomly divided into four groups:Propofol group (Group A), propofol combined with fentanyl group (Group B), propofol combined with remifentanil group (Group C), and propofol combined with sufentanil (Group D). Each group was100cases. Continuous monitoring of mean arterial pressure (mean arterial pressure MBP), electrocardiogram (electrocar-diogram, ECG), heart rate (heart rate, HR), and pulse oxygen saturation (pulse oxygen saturation, SpO2) were recorded before anesthesia (T1),2min after anesthesia (T2),cervical dilatation (T3),1min after operation (T4). Other parameters were also recorded including total dosage of propofol, intraoperative body movement, recovery time and hospital stay time. Patients were asked whether there was any memory during the surgical process. VAS (Visual analogue Scale) was measured to assess the postoperative pain with different anesthetic drugs, a telephone survey about the satisfaction of anesthesia with patients within three days, and a survey about the satisfaction of anesthesia with surgeons. Concluding all sets of data, Statistical analysis was performed with repeated measures of One-way ANOVA followed by Bonferroni post hoc test.Results:1. In the different groups of patients, no significant difference was observed in the age, body weight,gestational age operation time (P>0.05).2. In the comparison between different groups, the recovery time was significantly longer in Group A, whereas there were no significant difference between Group B,C,D in recovery time.As compare with Group B,C,D, patients in Group A spent significant longer time in the hospital (P<0.05),and Group B spent significant less time in hospital than Group C and D(P<0.05).3.There was statistically significant difference in different groups in the VAS. The scale was lowest in Group A compare with other groups,(P<0.05) whereas the scale was highest in Group C among group B,C,D.(P<0.05)4. Comparing the satisfaction of analgesia in the telephone survey: Group A got the lowest satisfaction compare with other groups,(P<0.05) and the scale was highest in Group C among group B,C,D.(P<0.05)5.Comparing the satisfaction of surgeon after the surgery:Group A got the lowest satisfaction compare with other groups,(P<0.05) and the scale was highest in Group C among group B,C,D.(P<0.05)6.There was no statistically significant difference in the value of MAP,HR,and SPO2in the different groups of patients preoper-atively(P>0.05),and no statistically significant difference in MAP,HR in different groups of patients at each time points after analgesia (T2,T3,T4)(P>0.05). There was no statistically significant difference in SPO2between four groups at time points T3and T4(P>0.05), whereas the scale of SPO2was lower in Group D at T2compared to other groups(P<0.05). A significant decline in MAP, HR,SPO2was observed in all groups at T2(P<0.05),whereas the change in MAP,HR,SPO2between T3,T4and T1was not satistically significant(P>0.05).7. The usage of propofol was the largest in Group A(P<0.05), which is significant different with other groups, whereas there was no difference in Group B,C,D.(P>0.05) 8. Comparing the effect of analgesia:There were significantly more intraoperative movement and operative awareness in Group A compare with other groups(P<0.05), and the percentage of intraoperative movement and operative awareness was higher in Group D compared with Group B and C(P<0.05).Conclusion:This study showed that the different anesthetic regimens can meet the operation requirements. Considering the the usage of drugs, recovery time, leaving timed and abdominal pain. However, sufentanil could reduce the dosage of propofol, shorten the recovery time and time spent in the operation theatre, and provide better analgesia in the artificial abortion operation, Especially the high satisfaction of patients and surgeons, it can also improve the hospital’s economic benefit and reputation.Thus, sufentanil may be an ideal adjunct analgesic for the painless artificial abortion under propofol anesthesia.