Observation on the effects of alfentanil combined with comfort nursing on the anesthesia efficacy and safety of abortion surgery
阿芬太尼联合舒适性护理对于人流手术麻醉效果与安全性的影响观察

摘要

目的 观察阿芬太尼联合舒适性护理对于人流手术麻醉效果与安全性的影响。方法 选取2022年10月-2023年9月间在本院行无痛人流手术的60例患者，随机分成对照组与研究组，分别为30例，对照组的麻醉药物为瑞芬太尼+丙泊酚，给予舒适性护理，研究组的麻醉药物为阿芬太尼+丙泊酚，同样给予舒适性护理，比较两组患者的应激反应、术中加药情况、疼痛情况、不良反应等。结果 从入室后（T1）、麻醉药物起效时（T2）、手术开始时（T3）、手术结束时（T4）、术后清醒时（T5）两组患者的心率、呼吸频率、平均动脉压来看，研究组患者的3项指标变化比较平缓，其中T4、T5时点的心率显著低于对照组（P＜0.05），T2、T4、T5时点的呼吸频率显著低于对照组（P＜0.05），T2、T3、T4时点的平均动脉压显著低于对照组（P＜0.05）；两组患者的术中追加麻醉药物率、低血压发生率均无统计学差异（P＞0.05）；入复苏室、清醒后10min、20min、30min对照组患者的VAS疼痛评分分别为（1.92±0.16）分、（1.54±0.12）分、（1.32±0.11）分、（1.14±0.09）分，研究组分别为（1.76±0.14）分、（1.38±0.10）分、（1.20±0.10）分、（1.03±0.08）分，均显著低于对照组（P＜0.05）；对照组患者的不良反应发生率为50.00%（15/30）,研究组为23.33%（7/30），显著低于对照组（P＜0.05）。结论 阿芬太尼联合舒适性护理应用于人流手术麻醉，有利于维持心率、呼吸频率、平均动脉压稳定，减轻疼痛程度，减少不良反应，具有较好的麻醉效果与较高的安全性。

Abstract

Objective To observe the effects of alfentanil combined with comfort nursing on the anesthetic efficacy and safety of abortion surgery.
Methods Sixty patients who underwent painless abortion surgery in our hospital from October 2022 to September 2023 were randomly divided into a control group and a study group, with 30 patients in each group. The control group received remifentanil + propofol as anesthetic and received comfort nursing, while the study group received alfentanil + propofol as anesthetic and received the same comfort nursing. The stress response, intraoperative medication administration, pain level, and adverse reactions were compared between the two groups.
Results From the perspectives of heart rate, respiratory rate, and mean arterial pressure in the two groups of patients upon admission (T1), when anesthetic drugs take effect (T2), at the start of surgery (T3), at the end of surgery (T4), and upon postoperative awakening (T5), the changes in these three indicators in the study group were relatively gradual. Specifically, the heart rate at T4 and T5 was significantly lower than that in the control group (P < 0.05), the respiratory rate at T2, T4, and T5 was significantly lower than that in the control group (P < 0.05), and the mean arterial pressure at T2, T3, and T4 was significantly lower than that in the control group (P < 0.05). There were no statistically significant differences between the two groups in the rate of intraoperative additional anesthetic drugs and the incidence of hypotension (P > 0.05). Upon admission to the recovery room, [further details about the recovery process are needed]. At 10, 20, and 30 minutes after awakening, the VAS pain scores of the control group were (1.92±0.16), (1.54±0.12), (1.32±0.11), and (1.14±0.09), respectively, while those of the study group were (1.76±0.14), (1.38±0.10), (1.20±0.10), and (1.03±0.08), respectively. Both scores were significantly lower than those of the control group (P<0.05). The incidence of adverse reactions was 50.00% (15/30) in the control group and 23.33% (7/30) in the study group, significantly lower than that of the control group (P<0.05).
Conclusion   Alfentanil combined with comfort care for invasive abortion surgery anesthesia helps maintain stable heart rate, respiratory rate, and mean arterial pressure, reduces pain intensity, and minimizes adverse reactions, demonstrating good anesthetic efficacy and high safety.