小剂量氯胺酮配伍丙泊酚用于人工流产手术麻醉  

Different Dosage of Propofol with Small-dose Ketamine for Painless Artificial Abortion

作　　者：陈建军[1] 刘丽[1] 徐威[1] 徐文庆[1] 

机构地区：[1]复旦大学附属金山医院麻醉科,上海200540

出　　处：《中国临床医学》2007年第4期564-565,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨小剂量氯胺酮配伍丙泊酚在人工流产手术中的应用价值和适合剂量。方法:ASAⅠ～Ⅱ级人工流产患者120例,随机分为4组,每组30例。Ⅰ组为对照组,单纯输注丙泊酚;Ⅱ、Ⅲ、Ⅳ组分别先静脉注射氯胺酮0.2 mg·kg^(-1)、0.4 mg·kg^(-1)、0.6 mg·kg^(-1),再输注丙泊酚。观察患者平均动脉压(MAP)、心率(HR)及脉搏血氧饱和度(SpO_2),术中镇痛效果与丙泊酚用量,术后清醒时间与精神不良反应发生率。结果:Ⅰ组MAP、HR及SpO_2术中均值较术前基础值下降(P<0.05),Ⅱ、Ⅲ、Ⅳ组无差异(P>0.05);Ⅱ组镇痛效果与丙泊酚用量与Ⅰ组比较无差异(P>0.05);Ⅳ组精神不良反应发生率高于Ⅰ、Ⅱ、Ⅲ组,清醒时间较Ⅰ、Ⅱ、Ⅲ组长(P<0.05);Ⅲ组较Ⅰ组镇痛效果优,丙泊酚用量少,清醒时间短(P<0.05),精神不良反应发生率与Ⅰ组比较无差异(P>0.05)。结论:0.4 mg·kg^(-1)氯胺酮配伍丙泊酚用于人工流产手术,患者循环呼吸稳定,镇痛充分,并可显著减少丙泊酚用量,且术后清醒迅速,极少发生精神不良反应,可作为临床应用的参考剂量。Objective.. To explore the application value and suitable dosage of propofol combined with small-dose ketamine in induced abortion. Methods： 120 induced abortion patients were randomly divided into 4 groups（n = 30 cases）： Group Ⅰ （control group）was administrated propofol only; group Ⅱ , Ⅲ , Ⅳ were administrated ketamine 0.2, 0.4, 0.6mg·kg^-1 before propofol, respectively, mean arterial pressure（MAP）, Heart Rate（HR）, Pulse oxygen saturation（SpO2 ）, analgesic effect, recovery time,the dosage of propofol and psychical side effect were observed. Results： MAP, HR, SpO2, during operation were significantly lower than those of preoperation respectively in group Ⅰ （P〈0.05）, but their changes are not significant in group Ⅱ , Ⅲ and Ⅳ （P〈0.05）. The analgesic effect had no difference between group Ⅰ and Ⅱ （P〉0.05）. Psychical side effect occurrence and recovery time increased in group Ⅳ （P〈0.05） ; there were better analgesic effect, less propofol dosage, less recovery time in group Ⅱ compared with in group Ⅰ （P〈0.05）, and no difference in psychical side effect occurrence （P〉0. 05）. Conclusion：0. 4 mg·kg^-1 ketanfine combined with propofol for artificial abortion may stabilize the circulation and respiration, enhance analgesia, reduce the propofol dosage, shorten the recovery time, and very few psychical side effect, is the reference dosage.

关 键 词：小剂量氯胺酮 丙泊酚 人工流产 镇痛 

分 类 号：R614.2[医药卫生—麻醉学]