小剂量氯安酮、芬太尼对丙泊酚麻醉无痛人流手术的观察  

Application of Low Dose of Ketamin and Fentanyl as Supplement to Propofol Anesthesia in Painless Artificial Abortion

作　　者：李卫[1] 张聪先 

机构地区：[1]四川省攀枝花市中西医结合医院麻醉科,攀枝花617000

出　　处：《麻醉与监护论坛》2006年第4期199-200,共2页Forum of Anesthesia and Monitoring

摘　　要：目的：探讨小剂量氯胺酮、芬太尼复合丙泊酚麻醉在无痛人流手术的临床应用。 方法：自愿择期人流手术病人120例，年龄18-45岁，体重40-65公斤，身高150-173cm，孕期34-73天，ASAⅠ-Ⅱ级，均无全身疾病，术前禁食6小时，禁饮4小时，随机分成3组（n=40）；丙泊酚组（A组），芬太尼复合丙泊酚组（B组）、小剂量氯胺酮，芬太尼复合丙泊酚组（C组）。A组丙泊酚缓慢静注麻醉诱导，当病人意识消失，持续泵注丙泊酚麻醉维持，必要时静推丙泊酚；B组先静注芬太尼1ug.kg^-1（最多50 ug），其余同A组；C组先静注芬太尼1 ug.kg^-1（最多50 ug），氯胺酮0.2mg.kg^-1（最多10 mg），再同A组。术中监测SBP、DBP、HR、SpO2、RR，评定镇痛效果，记录清醒时间，离院时间，丙泊酚用量；观察术中镇痛，术后宫缩疼痛情况。 结果：A、B、C三组病人年龄、体重、身高、孕期、手术时间比较差异无显著性，血压、心率变化相似，比较差异无统计学意义（P〉0.05）；三组中镇痛效果C组最好，A组最差，差异有显著性（P〈0.05）;术后宫缩痛C组最轻，A组最重，比较差异有统计学意义（P〈0.05），丙泊酚用量C组最少，A组最多，差异具有显著性（P〈0.05）. 结论：小剂量氯胺酮、芬太尼复合丙泊酚用于无痛人流手术，麻醉满意。镇痛效果好，具有临床应用价值。Objective：To valuate the efficacy and the safety of low dose Ketamin and Fentanyl as supplement to Propofol anesthesia in artificial abortion. Methods：One hundred twenty ASAⅠ-Ⅱpregnant women undergoing painless abortion were enrolled in this study and randomly divided into three groups with forty in each.The women in group Areceived propofol anesthesia alone;In group B,patients ere administrated intravenously 1 ug.kg^-1 fentanyl and propofol;In group C,0.2mg.kg^-1 ketamin and 1 ug.kg^-1 fentanyl ere used in combination with propofol.SBP,DBP,HR,SpO2,RR,recovery time,hospital stay time,propofol dosage,postoperative uterotonic pain in three groups were compared. Results：Propofol dosage,postoperatie uterotonic pain in group A were most in the three groups,and were significantly more than that in group C were lest（P〈0.05）.There were no statistical significances among the three groups in bloob pressure,heart rate and SpO2. Conclusion：Low dose ketamin and fentanyl can reduce propofol dosages and strength analgesia effect of propofol without more side effects when used as supplement to propofol anesthesia when in painless artificial abortion.

关 键 词：氯胺酮 芬太尼 丙泊酚 无痛人流术 

分 类 号：R719.8[医药卫生—妇产科学]