Application of remifentanil plus propofol-etomidate anesthesia in painless abortion

Abstract:

Objective：To observe the effect of single intravenous injection of remifentanil plus propofol，remifentanil plus etomidate and remifentanil plus etomidate-propofol mixture in painless abortion anesthesia，so as to explore an ideal anesthetic method for painless abortion. Methods：A total of 300 early pregnant women of ASAⅠ-Ⅱ who accepted painless abortion voluntarily were ran－domly divided into propofol group（group P），etomidate group（group E） and etomidate mixed propofol group（group EP）. Mean arte－rial pressure（MAP），heart rate（HR） and percutaneous oxygen saturation（SpO2） before anesthesia（T0），one minute after anesthesia （T1），one minute after the operation（T2） and one minute post operation（T3） were recorded in each group. Adverse events such as in－jection pain，myoclonus，nausea and vomiting were recorded. Effect of anesthesia satisfaction were evaluated for obstetrics and gy－necology doctors and patients respectively. Results：In T0 and T3，there was no significant difference in MAP，HR and SpO2 among the three groups（P>0.05）. MAP，HR and SpO2 of group E and EP in T1 and T2 were higher than those in group P（P<0.05）；the inci－dence of injection pain，intraoperative hypotension and bradycardia in group P was higher than that in group E and group EP（P<0.05）. The incidence of myoclonus in group E was higher than that in group P and EP（P<0.05）. There was no significant difference in the incidence of intraoperative movement，additional drugs，nausea，vomiting and hypoxia saturation among the three groups（P>0.05）. In terms of satisfaction with anesthesia effect，gynecologists and obstetricians had high satisfaction with group P and EP（P<0.05），while patients themselves had higher satisfaction with the two groups（P<0.05）. Conclusion：In painless abortion，single intrave－nous injection of remifentanil plus EP mixture is a better choice than remifentanil plus propofol and remifentanil plus etomidate，in maintaining hemodynamic stability，reducing in－jection pain and myoclonus，getting higher satisfaction with surgery doctors and patients.