Painless Abortion Research Articles

Efficacy and Safety of Remimazolam Tosilate Combined with Butorphanol Tartrate for Painless Abortion and the Effect of Postoperative Nursing Combined with Buxue Yimu Granule on Nutritional Status of Patient

This study aimed to assess the efficacy and safety of remimazolam tosilate combined with butorphanol tartrate for painless abortion and the effect of postoperative nursing on patients’ nutritional status. A total of 110 patients who underwent painless abortion were divided into control and research groups. The excellent and good rates in the research group (98.18%) were relatively higher than those in the control group (85.45%). Compared with the control group, the research group had shorter wakeup and discharge times from the hospital. The incidence of adverse reactions was significantly lower in the research group (3.64%) than in the control group (14.55%). The amount of bleeding and bleeding time in the research group were reduced compared to those in the control group. After the intervention, albumin, prealbumin, and transferrin levels were higher in the research group than in the control group. In summary, remimazolam tosilate combined with butorphanol tartrate had an effective analgesic effect and increased safety in patients with painless abortion. Meanwhile, Buxue Yimu granule can promote physical rehabilitation, reduce adverse reactions, and improve the nutritional status of patients with painless abortions.

Efficacy Analysis of Misoprostol Tablets for Painless Abortion

Objective: To analyze the application value of misoprostol tablets in painless abortion. Methods: 40 patients who received painless abortion from January 2022 to August 2023 were randomly divided into two groups; those who received misoprostol tablets before the operation were included in group A, and those who did not use misoprostol tablets before the operation were included in group B. Differences in cervical laxity, cervical dilatation time, uterine aspiration time, surgical blood loss, complications, and satisfaction were recorded. Results: The excellent and good rate of cervical dilation in group A was higher than that in group B (P < 0.05); the dilatation time, uterine suction time, surgical blood loss, and other indicators in group A were better than those in group B (P < 0.05); the complication rate after abortion in group A was lower than that of group B (P < 0.05); satisfaction rate in group A was higher than that of group B (P < 0.05). Conclusion: Oral administration of misoprostol tablets before painless abortion can relax the cervix, shorten the dilation time of the cervix, reduce intraoperative bleeding, and have higher patient satisfaction.

Factors Associated with the Choice of Contraceptive Method following an Induced Abortion after Receiving PFPS Counseling among Women Aged 20-49 Years in Hunan Province, China.

There is limited research on postabortion family planning (PAFP) services and subsequent contraception in China. The current study aimed to identify women's contraceptive methods choices and associated factors after receiving PAFP services. A cross-sectional study used a cluster, stratified and multistage random sample to collect data. All eligible data were analyzed using SPSS 26.0. The chi-square test was used to assess the association between categorical variables. Significant variables (p < 0.05) and all potential variables were then included in the binary logistic regression model for analysis. Approximately 84.7% (1043/1231) of participants had received pre-abortion PAFP counselling, and approximately 90% of them chose reliable methods. Farmers or workers (OR = 0.297, 95% CI: 0.130-0.683), family monthly income (3000-4999 RMB, OR = 0.454, 95% CI: 0.212-0.973; ≥5000 RMB, OR = 0.455, 95% CI: 0.228-0.909), reliable advice from services providers before abortion (OR = 0.098, 95% CI: 0.039-0.250), painless surgical abortion (OR = 3.465, 95% CI 1.177-10.201), and postabortion follow-up (OR = 0.543, 95% CI: 0.323-0.914) and were associated with contraception choice after receiving PAFP services. This study emphasizes the importance of pre-abortion PAFP counselling, postabortion follow-up, and increased focus on women who have experienced painless abortion. The study provides direction for PAFP services policymakers, as well as a reference for contraceptive counselling research around the world.

Retracted: Effect of Propofol Intravenous Anesthesia Combined with Press-Needle Therapy on Analgesic Effect during Painless Abortion.

[This retracts the article DOI: 10.1155/2022/6543211.].

Effect of different doses of esketamine compared with fentanyl combined with propofol on hypotension in patients undergoing painless abortion surgery: a prospective, randomized, double-blind controlled clinical trial

BackgroundOpioids analgesics commonly used in abortion procedures are associated with respiratory and circulatory depression. Esketamine is a N-methyl-D-aspartate receptor (NMDA) antagonist and a common analgesic. The drug has several advantages including rapid onset and offset and it causes minimal cardiorespiratory depression. However, studies have not explored the effects of esketamine in patients undergoing painless abortion surgery. Therefore, the present study sought to evaluate the effect of different doses of esketamine compared with the effect of fentanyl on incidence of perioperative hypotension in patients undergoing painless abortion surgery and to explore the optimal esketamine dose for this population.MethodsA total of 178 female patients undergoing painless abortion surgery were enrolled to the current study. The patients were aged 18–45 years, had a body mass index (BMI) of 18–28 kg m− 2 and a class I or II physical status as determined using the American Society of Anesthesiologists (ASA) system. Patients were randomly assigned to four groups as follows: group F (n = 45) in which patients underwent intravenous (IV) administration of 1 μg kg− 1 fentanyl followed by IV administration of 2 mg kg− 1 propofol, and group EL, group EM and group EH (n = 45, 44, 44) with patients receiving IV administration of 0.2 mg kg− 1, 0.25 mg kg− 1, 0.3 mg kg− 1 esketamine, respectively, followed by IV administration of 2 mg kg− 1 propofol. The primary outcome of the study was the incidence of hypotension whereas secondary outcomes included incidence of adverse events, perioperative changes of vital signs, anesthesia induction time, recovery time and dischargeable time, propofol addition, as well as patient, surgeon and anesthesiologist satisfaction levels.ResultsThe findings showed that the incidence of hypotension was significantly lower in subjects in group EL, group EM and group EH (0, 0, 0%) relative to the incidence in patients in group F (20%) (χ2 = 19.648; P = 0.000). In this study, the incidence of hypoxia of subjects in group EL, group EM and group EH (0, 2.3, 2.3%) was significantly lower compared with that of patients in group F (11.1%) (χ2 = 8.622; P = 0.035). The findings indicated that the incidence of somatic motor reactions was significantly lower in participants in group EM and group EH (9.1, 4.5%) relative to that of patients in group F and group EL (26.7, 15.6%) (χ2 = 10.254; P = 0.016). The results showed that the incidence of nausea and vomiting and potential psychiatric symptoms were significantly higher in patients in group EH (15.9, 11.4%) compared with that of participants in group F (2.2, 0%), group EL (4.4, 0%) and group EM (2.3, 2.3%) (χ2 = 7.493; P = 0.038 and χ2 = 8.248; P = 0.003). In this study, the mean arterial pressure (MAP) and heart rate (HR) of subjects in group EL, group EM and group EH were more stable compared with that of patients in group F. Frequency of the additional propofol dose was markedly less in group EM and EH (26.7%, 17,8%) compared with that in group F and EL (9.1, 4.5%) (χ2 = 10.254; P = 0.016). The findings indicated that the dischargeable time was significantly shorter for patients in group EM compared with that of subjects in group F, group EL and group EH.ConclusionsThe findings of the present study showed that single-dose esketamine (0.25 mg kg− 1) effectively decreased incidence of hypotension and total adverse events and reduced the frequency of additional propofol dose required for patients undergoing painless abortion with preservation of physician-patient satisfaction.

Effect of Propofol Intravenous Anesthesia Combined with Press-Needle Therapy on Analgesic Effect during Painless Abortion.

Objective To discover the effect of propofol intravenous anesthesia along with press-needle therapy on analgesic effect during painless abortion. Methods A total of 128 cases who experienced painless abortion in our hospital from January 2019 to August 2021 were recruited as the research subjects. They were categorized into control and observation groups through the haphazard number table approach, with 64 patients in each group. Propofol intravenous anesthesia was given to the control group, and the observation group was given combined anesthesia with press-needle on this basis. Ramsay score, hemodynamic indexes, operation-related indexes, and postoperative recovery were studied between the two groups before anesthesia (T0), at the time of uterine aspiration (T1), promptly following the operation (T2), and at the recovery time of directional force (T3). The stress state and the level of pain mediators in the two groups of sufferers were observed at each time period, and the visual analogue scale (VAS) was employed to assess the degree of postoperative uterine contraction pain. Results Ramsay score at T1 and T2 time points in observation group was lesser than that in control group (P < 0.05). There existed no meaningful discrepancies in operation time and recovery time between both groups (P > 0.05). The total dosage of propofol in the observation group was lesser compared to that in the control group, and the recovery time of directional force was much shorter compared to that in the control group (P < 0.05). There existed no meaningful discrepancies in perioperative diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) between both groups (P > 0.05). The levels of norepinephrine (NE), cortisol (Cor), glucose (GLU) and substance P (SP), prostaglandin E2 (PGE2), and 5-hydroxytryptophan (5-HT) in the observation group were lesser than those in the control group immediately after surgery and 24 hours following the operation (P < 0.05). There existed no meaningful discrepancies in vaginal bleeding time, endometrial thickness 3 weeks after operation, and time to start menstruating between both groups (P > 0.05). The score of VAS for the observation group was lesser than that of the control group at 10 min and 30 min after operation (P < 0.05). There existed no substantial discrepancy in the incidence of negative reactions between both groups (P > 0.05). Conclusion Propofol intravenous anesthesia combined with press-needle therapy can ameliorate the analgesic impacts during painless abortion, reduce postoperative uterine contraction pain, inhibit the release of postoperative pain mediators, and improve the stress state of the body.

Efficacy of Analgesic Propofol/Esketamine and Propofol/Fentanyl for Painless Induced Abortion: A Randomized Clinical Trial.

Background Patients have widely accepted abortion as a remedy for contraceptive failure all over the world. Esketamine is a new anesthetic, sedative, and analgesic drug. Fentanyl is an opioid receptor agonist and a commonly used sedative. It is necessary to choose appropriate sedative drugs for painless abortion. Methods We selected 238 cases of painless induced abortion from January 2020 to January 2022. We collected surgical parameters, the performance of sedation, and postoperative scales with complications before and after the operation. SPSS 21.0 was used to analyze data. Results Surgical indicators between intervention and control groups had no difference; the preoperative indicators including intraoperative bispectral index (BIS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse oxygen saturation (SpO2) had no difference between the two groups. But after surgery, experiment groups had a higher value than the control group in these four indicators. The incidence of postoperative complications including nausea and vomit had no significant difference while the experiment group had a lower r-value than the control group in hypotension, bradycardia, decreased oxygen saturation, and respiratory depression. The postoperative VAS score and Ramsay score in the experimental group were lower than those in the control group. Conclusion Since esketamine had better sedation performance, reduce the risk of cardiovascular and respiratory depression during sedation, and reduce the pain scale compared with fentanyl, we supported that propofol/esketamine is a good choice for patients receiving a painless induced abortion, and it is a sedation plan worth promoting and further analysis.

Clinical Effect of Psychological Nursing in Painless Abortion Nursing

Clinical Effect of Psychological Nursing in Painless Abortion Nursing

Analysis of the Effect of Traditional Chinese Medicine Nursing Intervention on Patients after Painless Abortion

Analysis of the Effect of Traditional Chinese Medicine Nursing Intervention on Patients after Painless Abortion

Incidence and Risk Factors for Hypoxia in Deep Sedation of Propofol for Artificial Abortion Patients.

BackgroundRespiratory depression is a life-threatening adverse effect of deep sedation. This study aimed to investigate the factors related to hypoxia caused by propofol during intravenous anesthesia.MethodsThree hundred and eight patients who underwent painless artificial abortion in the outpatient department of Shanghai Tenth People’s Hospital between November 1, 2019 and June 30, 2020 were divided into two groups according to whether the patients experienced hypoxia (SpO2 < 95%). Preoperative anxiety assessments, anesthesia process, and operation-related information of the two groups were analyzed. The univariate analysis results were further incorporated into logistic regression analysis for multivariate analysis to determine the independent risk factors affecting hypoxia.ResultsUnivariate analysis revealed that body mass index (BMI) (21.80 ± 2.94 vs. 21.01 ± 2.39; P = 0.038, 95% confidence interval (CI) = [−1.54, −0.04]), propofol dose (15.83 ± 3.21 vs. 14.39 ± 3.01; P = 0.002, CI = [−2.34, −0.53]), menopausal days (49.64 ± 6.03 vs. 52.14 ± 5.73; P = 0.004, CI = [0.79, 4.21]), State Anxiety Inventory score (51.19 ± 7.55 vs. 44.49 ± 8.96; P < 0.001, CI = [−9.26, −4.15]), and Self-rating Anxiety Scale score (45.86 ± 9.48 vs. 42.45 ± 9.88; P = 0.021, CI = [−6.30, −0.53]) were statistically significant risk factors for hypoxia during the operation. Logistic regression analysis showed that propofol dosage, menopausal days, and State Anxiety Inventory score were independent risk factors for hypoxia.ConclusionPatient anxiety affects the incidence of hypoxia when undergoing deep intravenous anesthesia with propofol. We can further speculate that alleviating patient anxiety can reduce the incidence of hypoxia.Clinical Trial Registration[http://www.chictr.org.cn], identifier [ChiCTR2000032167].

Clinical Observation of Misoprostol before and after Painless Induced Abortion

Background: Though painless abortion is a safe, effective and excellent method of artificial abortion, intravenous anesthesia cannot effectively expand the cervix. Hard and tight cervix often affects the operation and easily inducesabortion complications. Misoprostol can induce uterine contraction and soften the cervix. Objective: To investigate the clinical effect of misoprostol on abortion before and after painless induced abortion. Methods: 600 case pregnant women were divided into three groups: A, B and C, 200 case in each group. All patients were anesthetized. In group A, misoprostol 0.2 ug was placed in the posterior fornix of vagina 2 hours before the operation of induced abortion; in group B, misoprostol 0.2 ug was not only placed in the posterior fornix of vagina 2 hours before the operation of induced abortion but also taken orally 2 hours and 6 hours after the operation; in group C, misoprostol was not used before and after the operation. The operation time, intraoperative bleeding volume, postoperative bleeding, the percentage of cervical relaxation and the rate of incomplete abortion among the three groups were compared. Results: Compared with group A and group B, the operation time of group C was longer and the amount of bleeding was more (P 0.05). The duration of bleeding in group B was less than that in group A (P Conclusion: The use of misoprostol before and after painless induced abortion can not only shorten the time of operation, reduce intraoperative and postoperative vaginal bleeding, but also has not incurred incomplete abortion(primary outcome).

Study on the Clinical Effect of Dezocine and Remifentanil Combined with Propofol in Anesthesia for Painless Abortion

Objective: To investigate the anesthetic effect of dezocine and remifentanil combined with propofol in painless artificial abortion. Methods: 90 cases in total of painless induced abortion in our hospital from May 2017 to May 2020 were retrospectively analyzed, 29 cases of propofol anesthesia (group A), 29 cases of dezocine combined with propofol anesthesia (group B), and 32 cases of remifentanil combined with propofol anesthesia (group C) were compared the anesthesia situation. Results: Compared with the cases in group A, the incidence of pain, body movement and SPO2&lt;90% at the injection site were lower in group B and group C, the use of propofol was reduced, and the VAS scores were lower when the patients begin to awake, and the efficiency was higher than that in group A(P&lt;0.05); there was no statistic difference in the changes of SBP, DBP and HR index data in the operation time, postoperative awake time, and preoperative, intraoperative and postoperative time points of the three groups(P&gt;0.05). Conclusion: Dezocine and remifentanil combined with propofol for painless artificial abortion anesthesia has more significant effect than propofol anesthesia alone, which can relieve patients' pain and reduce the chance of respiratory depression.

Analysis of risk factors and prognosis for intrauterine adhesion after hysteroscopic submucosal myoma

Objective To explore the risk factors of intrauterine adhesions after abortion and the effect of hysteroscopic surgery. Methods Through retrospective analysis method, from January 2014 to October 2016, 80 artificial abortion patients with intrauterine adhesions were collected as adhesion group.During the same period, 80 patients without adhesion after artificial abortion were selected as non-adhesion group.The general data of the two groups were compared.By logistic multivariate analysis, the influencing factors of intrauterine adhesions were analyzed.And the effect of surgical treatment of hysteroscopic adhesion was analyzed. Results The adhesion group and the non-adhesion group had statistically significant differences in the times of pregnancy(t=6.848, P<0.001), missed abortion(t=12.004, P<0.001), painless curettage times(t=7.24, P<0.001), painless abortion history(χ2=5.079, P=0.024). Multivariate logistic regression analysis indicated that number of missed abortion(OR: 7.083, 95% CI: 2.406-17.392; P=0.002), curettage times(OR: 9.147, 95% CI: 2.875-32.068; P=0.014), painless abortion of history(OR: 5.276, 95% CI: 1.973-13.492; P=0.029) were the independent risk factors for uterine cavity adhesions (P<0.05). The total effective rate of the mild-to-moderate uterine cavity adhesions was significantly higher than that of the severe uterine cavity adhesions (χ2=16.449, P<0.001). Conclusion The number of missed abortion, curettage, painless history are independent risk factors for intrauterine adhesion, the effect of treatment is related to the degree of adhesion, hysteroscopic intrauterine adhesions after treated with the combination therapy of estrogen and Foley balloon catheter, IUD and absorbable membrane can help reduce the risk of readhesion, it is worthy of clinical attention. Key words: Abortion, induced; Postoperative complications; Risk factors; Prognosis

Effect of propofol combined with different analgesic drugs on painless induced abortion and its effect on body motion

Objective To compare the effects of propofol combined with fentanyl or dezocine on painless abortion and the influence on body movement. Methods From July 2016 to May 2017, 240 patients with voluntary painless abortion who aged 19-45 years old in the Second People's Hospital of Linhai, were randomly divided into 3 groups according to the digital table, with 80 cases in each group.D group was given propofol and dezocine; F group was given propofol combined with fentanyl; C group was the control group and was treated with propofol intravenous anesthesia, the three groups were given propofol added according to the specific situation.The operative time, recovery time and the total amount of propofol were compared among the three groups; and the pain visual analogue scale(VAS) at 0min, 15min, 30min, 1h, 3h were comparedamong the three groups; The incidence of respiratory depression and other adverse reactions were statistically analyzed in three groups. Results The operation time, recovery time, the total dosage of propofol in D group were (4.5±0.7)min, (1.2±0.3)min and (136.8±14.5)mg, respectively, which in F group were (4.6±0.8)min, (1.3±0.2)min and (139.6±12.1)mg, respectively, there were no statistically significant differences between the two groups (all P>0.05). The recovery time and total dosage of propofol in D group and F group were lower than those of C group[(2.4±0.6) min, (168.7±18.9) mg](t=25.298, 27.287, 11.977, 27.287, all P<0.05). The VAS scores at postoperative 0min, 15min, 30min, 1h, 3h in D group were lower than those in F group and group (t=34.785, 25.044, 25.043, 22.349, 28.622, 48.809, 42.278, 40.000, 42.278, 40.000, all P<0.05). The VAS scores at postoperative 0min, 15min, 30min, 1h in F group were lower than those of C group(t=36.978, 24.406, 19.846, 24.406, all P<0.05). The incidence rates of nausea, sedentary, respiratory depression, hypotension in D group were 1.3%(1case), 2.5%(2cases), 1.3%(1case), 0.0%(0cases), resperctively, which in F group were 0.0%(0cases), 3.8%(3cases), 3.8%(3cases), 2.5%(2cases), which in D group, F group were lower than those in C group [6.3%(5cases), 16.3%(13cases), 11.3%(9cases), 15.0%(12cases)](χ2=3.925, 3.657, 3.925, 3.657, 5.889, 3.152, 3.152, 3.657, all P<0.05). Conclusion Propofol combined with dezocine and fentanyl used in painless abortion have good effect, and the body movement is less, but propofol combined with dezocine has less postoperative pain degree. Key words: Anesthesia and analgesia; Abortion, induced; Propofol

超声引导下无痛人流的临床疗效研究

目的：探究超声引导下无痛人流的临床疗效。方法：在2016年1月至2017年4月选取所在科室92例无痛人流患者进行分析，采用随机抽签分类法将所有患者分为参照组和研究组，每组实验样本为46例，参照组采用常规无痛人流术治疗，研究组采用超声引导无痛人流术治疗，评估两组患者的手术效果以及术后并发症状发生率。结果：相对于参照组，研究组患者的手术效果更好，术后并发症状发生率更低，P < 0.05。结论：采用超声引导无痛人流术治疗无痛人流患者，患者的手术效果显著，术后并发症状发生率较低，值得临床借鉴。 Objective: To explore the clinical curative effect of ultrasound guided painless abortion. Methods: We selected and analyzed 92 patients with painless abortion in the department from January 2016 to April 2017, and the patients were divided into control group and research group by the random lottery taxonomy. The experimental samples of each group were 46 cases. The control group used conventional treatment of painless abortion, and the research group used the treatment of painless abortion guided by ultrasound. At last, we evaluated the operation effect of two groups of patients and the incidence of postoperative complication. Results: Compared with control group, the operation effect of research group patients was better and the incidence of postoperative complication was lower, P < 0.05. Conclusion: The painless abortion patients who were treated by ultrasound guided painless abortion, had remarkable operation effect, and the incidence of postoperative complication was lower. It was worthy of reference for clinical.

Meta analysis for the anesthesia effect and adverse reactions of etomidate and propofol on the painless abortion surgery

To evaluate the anesthesia effect of etomidate and propofol on painless abortion surgery. After screening the Cochrane Library, Pubmed, China National Knowledge Infrastructure (CNKI), WANFANG, VIP database, the literatures regarding the anesthesia effect of etomidate and propofol on painless abortion surgery were collected from 1995 to 2014. The randomized controlled trials (RCTs) were selected, the quality evaluation was performed and the data was analyzed by using RevMan5.3 software. A total of 1 130 patients were included in 9 RCTs. The results of Meta analysis were as follows: the anesthesia induction time in the etomidate group was less than that in propofol group (MD=-0.14, 95% CI -0.24 to -0.04, P=0.004); there were more adverse reactions, such as myoclonus, nausea and vomiting, in the etomidate group compared with the propofol group (P<0.001); the incidence of pain in the etomidate group was less than that in the propofol group (P<0.001); there was no significant difference in the incidence of respiratory depression between the 2 groups (P>0.05); the surgery time, analgesia and duration from withdrawal to the wake-up was not significantly different between the 2 groups (P>0.05). Etomidate had a shorter anesthesia induction time than propofol in the painless abortion surgery. The incidence of reverse reactions such as myoclonus, nausea and vomiting, was more common in application of etomidate, whereas the incidence of injection pain was more common in the use of propofol group. There was no significant difference in respiratory depression between the 2 drugs. The comprehensive efficacy of propofol is better than etomidate.

Clinical investigation of different fentanyl medication methods on propofol intravenous anesthesia painless abortion

Objective To investigate different fentanyl medication methods on propofol intravenous anesthesia painless abortion, to provide a reference for clinical treatment. Methods 120 patients undergoing painless abortion were selected, according to the random number table they were divided into Ciliao point group, subcutaneous group, intravenous injection group, 40 cases in each group.Intravenous injection group used intravenous anesthetic propofol, Ciliao point group used Ciliao hole injection anesthesia, subcutaneous group used fentanyl anesthesia subcutaneous injection.The anesthesia, analgesia and other clinical indicators of complications were compared among the three groups. Results The anesthesia excellent and good rate of Ciliao point group was 97.50%, which was higher than the subcutaneous group, intravenous injection group, the differences were significant(χ2=4.132, 3.894, all P 0.05).Postoperative 4h, 8h, VAS scores of Ciliao point group were (2.32±0.56)points, (1.13±0.23)points, which were lower than those in the subcutaneous group, intravenous injection group, the differences were significant (t=8.656, 8.843, 6.587, 6.335, all P<0.05).The propofol use times, the amount of Ciliao point group were (1.14±0.14), (116.37±14.35)mg respectively, which were less than those in the subcutaneous group, intravenous injection group, the differences were significant (t=6.645, 5.587, 6.132, 5.854, all P<0.05).The incidence rate of adverse reaction of Ciliao point group was 2.50%, which of the subcutaneous group was 20.00%, which of the intravenous group was 25.00%, the differences were statistically significant (χ2=6.596, 7.454, all P<0.05). Conclusion Fentanyl uased at Ciliao point can enhance the clinical effect of anesthesia with less postoperative pain and reduce incidence of adverse reactions, it is worthy of clinical application. Key words: Fentanyl; Propofol; Anesthesia

The effect of successive individualized nursing on patientswithultrasonic-guided painless induced abortion

Objective To discuss the practical effect of successive individualized nursing on patients with ultrasonic-guided painless abortion, in order to promote their physical and psychological health. Methods A total of 196 patients who had received ultrasonic-guided painless abortion were divided into two groups.In control group, all the 98 members were adopted the conventional nursing .Meanwhile, the successive individualized nursing was conducted into all the 98 members of observation group starting from their treatments after admitting to the hospital until their subsequent visits before discharging.The psychological status, related knowledge cognition degree about abortion, the surgery complication incidence, further consultation rate after operations and nursing service satisfaction and so on were observed and compared between the two groups. Results The psychological status, related knowledge cognition degree about abortion, further consultation rate after operations and nursing service satisfaction and so on in observation group were better than those in control group, the surgery complication incidence was lower than that in control group (P<0.05). Conclusions It is practicable for applying successive individualized nursing to the patients with ultrasonic-guided painless abortion.And it is favorable and worthy of consideration for the clinical applications. Key words: Successive; Individualized nursing; Ultrasonic-guided; Painless abortion

Comparison of the effects of different analgesia methods for artificial abortion

Objective To observe the clinical effect of multimodal analgesia for painless artificial abortion . Methods 150 cases of ASA Ⅰ-Ⅱ pregnancy received painless artificial abortion operation ,no contraindication for all patients,were randomly divided into the five groups ,30 cases in each group,the blank control group （group S）：do not use any analgesia measure ,intravenous injection of 0.9% sodium chloride 2mL preoperation;the fentanyl group （ F group ） ：intravenous injection of fentanyl 1μg/kg preoperation ;the parecoxib group （ group P ） ：intravenous injection of parecoxib sodium 40mg preoperation.The patients were given painless artificial abortion after injection the above drugs.Nerve block group （ N group）：the implementation of painless induced abortion operation after sleep in patients with the cervical nerve block ,injection of 1%lidocaine 2 mL.Multimodal analgesia group （group M）：intra-venous injection of parecoxib sodium 40mg,fentanyl 1μg/kg,then the implementation method the same as N group . The operation time,anesthesia onset time,recovery time,time of accurate orientation and additional dosage of propo-fol;incidence rate of artificial abortion syndrome ,the incidence rate of uterine contraction pain ,10min,30min,1h,6h pain scores after operation; adverse reaction;satisfaction score of analgesic effect postoperative 24h were observed. Results The additional dosage of propofol in the group S ,group F,group P,group N and group M were （78.45 ± 20.36）mg,（15.55 ±12.33）mg,（16.75 ±13.13）mg,（14.55 ±10.25）mg,（9.35 ±8.27）mg.The incidence rates of uterine contraction pain in the group S ,group F,group P,group N and group M were 30%,10%,10%,10%,0. Compared with group M ,the additional dosage of propofol and incidence rate of uterine contraction pain in the other four groups were significantly increased （t=3.05,1.82,1.84,1.78,χ2 =72.1,68.2,68.2,68.2,all P〈0.05）. Pain scores after operation 10min,30min,1h,6h in the group S were （6.6 ±1.5）points,（5.6 ±1.4）points,（4.6 ± 1.1）points,（3.6 ±1.4）points.Those in group F were （5.1 ±1.5）points,（4.3 ±1.1）points,（3.1 ±0.9）points, （2.8 ±0.8）.Pain scores after operation 10min,30min,1h,6h in the group P were （4.6 ±1.5） points,（4.2 ± 0.9）points,（2.9 ±0.8） points,（2.7 ±0.6） points.Those in the group N were （4.5 ±1.5） points,（4.1 ± 0.8）points,（2.9 ±0.8）points,（2.6 ±0.5）.Pain scores after operation 10min,30min,1h,6h in the group M were （2.2 ±0.8）points,（1.9 ±0.7）points,（1.5 ±0.5）points,（1.2 ±0.3）points.Compared with the group M,pain scores after operation 10min,30min,1h,6h in the other four groups were significantly elevated （ t=2.03,1.96,1.86, 1.84,1.98,1.82,1.80,1.76,2.05,1.99,1.95,1.86,2.06,1.88,1.82,1.76,all P〈0.05）.Compared with S group,postoperative 24h satisfaction score of analgesia in the group M was improved significantly （ t =1.98,P〈0.05）.Compared with group M,the incidence rate of nausea in the other four groups was increased significantly （χ2 =72.2,68.9,68.1,68.1,all P〈0.05）.Conclusion Multimodal analgesia method can greatly reduce artificial abor-tion postoperative pain ,reduce the adverse reactions ,improve patients＇satisfaction score ,ensure the safety of operation . Key words: Abortion,artificial; Analgesia; Abortion,artificial; Analgesia; Abortion,artificial; Analgesia

The advantage and clinical application of remifentanil administered by target-controlled infusion

Background Remifentanil is a novel, short-acting μ-opioid receptor agonist. Its context-sensitive half-time is very short, and there is no accumulation of effects after remifentanil withdrawal, regardless of time of administration. The pharmacokinetic characteristics make remifentanil suitable for administration by target-controlled infusion (TCI). Objective To evaluate the advantage and disadvantage of remifentanil administered by TCI in order to facilitate its improvement. Content Remifentanil administered by TCI is easy to be controlled and can provide a steady haemodynamics. Dosage of other anesthetics can be reduced when used along with remifentanil TCI. Remifentanil administered by TCI can apply to various types of anesthesia, such as induction and maintenance of general anesthesia, awake intubation, painless abortion and local block. Disadvantages existed in this TCI include imperfection of pharmacokinetics model for Chinese, limited ability of technique for measuring blood concentration of remifentanil, and lack of effective monitoring indicators for pain, which need to be researched further. Trend Improvement of the current remifentanil TCI will make it gain a wider application in clinical anesthesia. Key words: Remifentanil; Target-controlled infusion; Pharmacokinetics