Sedation and analgesia effect of intranasal drip with dexmedetomidine in induced abortion

Abstract

Objective To study the sedation and analgesia effect of intranasal drip with dexmedetomidine in induced abortion. Methods Three hundred patients scheduled underwent induced abortion from April 2014 to January 2015 in the Second Affiliated Hospital of Dalian Medical University were selected. The patients were divided into P group, DP group and SP group by random digits table method with 100 cases in each group. The patients of P group received 0.9% sodium chloride intranasal drip and 0.9% sodium chloride and propofol intravenous injection, the patients of DP group received dexmedetomidine intranasal drip and 0.9% sodium chloride and propofol intravenous injection, the patients of SP group received 0.9% sodium chloride intranasal drip and sufentanil and propofol intravenous injection. The operation time, oxytocin dose, recovery time, recovery to leave the operating bed time, recovery to discharge time, blood loss, quality of aspirated tissue, propofol additional dose, propofol total dose, uterine contraction pain score, adverse reactions, satisfaction rate of doctors, satisfaction rate of patients and satisfaction rate of hand operation conditions were compared among 3 groups. Results There were no statistical differences in operation time, recovery time, recovery to leave the operating bed time, recovery to discharge time, quality of aspirated tissue and incidence of adverse reactions among 3 groups (P>0.05). The blood loss, oxytocin dose, propofol additional dose and propofol total dose in DP group were significantly lower than those in P group and SP group: (5.0 ± 3.2) ml vs. (7.5 ± 3.8) and (10.0 ± 3.4) ml, (7.0 ± 3.3) U vs. (10.0 ± 3.1) and (12.0 ± 2.9) U, (0.52 ± 0.02) mg/kg vs. (0.81 ± 0.04) and (0.75 ± 0.02) mg/kg, (1.5 ± 0.3) mg/kg vs. (2.8 ± 0.4) and (2.6 ± 0.5) mg/kg, there were statistical differences (P<0.05). The uterine contraction pain score immediate postoperative, postoperative 15 min and postoperative 30 min in DP group was significantly lower than that in P group and SP group: (3.1 ± 0.2) scores vs. (5.1 ± 0.9) and (3.9 ± 0.3) scores, (3.0 ± 0.6) scores vs. (5.0 ± 0.7) and (3.8 ± 0.8) scores, (2.8 ± 0.3) scores vs. (5.0 ± 0.5) and (3.3 ± 0.4) scores, the score in SP group was significantly lower than that in P group, and there were statistical differences (P<0.05). The satisfaction rate of doctors, satisfaction rate of patients and satisfaction rate of hand operation conditions in DP group were significantly higher than those in P group and SP group: 95.0% (95/100) vs. 10.0% (10/100) and 60.0% (60/100), 75.0% (75/100) vs. 15.0% (15/100) and 65.0% (65/100), 90.0% (90/100) vs. 30.0% (30/100) and 80.0% (80/100), the satisfaction rates in SP were significantly higher than those in P group, and there were statistical differences (P<0.05). Conclusions Sedation with intranasal drip dexmedetomidine (1 μg/kg) provides effective antianxiety, reduces dose of propofol and blood loss in induced abortion. Compared with propofol or propofol combined with sulfentanil, dexmedetomidine intranasal drip combined with propofol intravenous injection has higher satisfaction scores of patients and doctors, and no obvious adverse reactions. Key words: Abortion, induced; Administration, intranasal; Dexmedetomidine