小剂量艾司氯胺酮对无痛人流麻醉血流动力学指标及术后宫缩痛的影响  

Effects of Low Dose of Esketamine on Hemodynamic Indexes and Postoperative Contractions of Painless Induced Abortion

作　　者：陆艳萍 沈勇桃 范建萍 LU Yanping;SHEN Yongtao;FAN Jianping(Department of Anesthesiology,jiangsu Shengze Hospial Afliated to Nanjing Medical University,Suzhou 215228,Jiangsu,China)

机构地区：[1]南京医科大学附属江苏盛泽医院麻醉科,江苏苏州215228

出　　处：《中国药物滥用防治杂志》2022年第8期1068-1071,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:分析小剂量艾司氯胺酮对无痛人流麻醉血流动力学指标及术后宫缩痛的影响。方法:选择南京医科大学附属江苏盛泽医院自2019年1月至2022年1月接诊80例行无痛人流的患者作为研究对象,分为两组,分别为对照组、观察组,每组40例。对照组单用丙泊酚,观察组在对照组基础上加用小剂量艾司氯胺酮。比较两组血流动力学指标[平均动脉压(MAP)、心率(HR)]及宫缩痛程度[视觉模拟疼痛评分(VAS)]、术后恢复指标[睫毛反射消失时间、手术时间、丙泊酚用量、苏醒时间、定向力恢复时间]及围麻醉期不良反应发生情况。结果:观察组术毕苏醒时MAP、HR均大于对照组(P<0.05);观察组术后苏醒即刻、15、30、60 min的VAS评分均低于对照组(P<0.05);观察组睫毛反射消失时间、苏醒时间、定向力恢复时间短于对照组,丙泊酚用量少于对照组(P<0.05);观察组围麻醉期不良反应发生率为22.50%,低于对照组的44.50%(P<0.05)。结论:小剂量艾司氯胺酮能有效提高无痛人流麻醉效果,有助于稳定血流动力学和减小术后宫缩痛,且安全性较好。Objective:To analyze the effect of low-dose es ketamine on hemodynamic parameters of painless induced abortion anesthesia and postoperative uterine pain.Methods:A total of 80 patients with painless induced abortion admitted to Shengze Hospital Affiliated to Nanjing Medical University from January 2019 to January 2022 were selected and divided into two groups,namely the control group and the observation group,with 40 cases in each group.The control group was treated with propofol alone,and the observation group was treated with small dose of esclamide on the basis of the control group.The hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR)],degree of uterine contraction pain[visual analogue pain score(VAS)],postoperative recovery indexes[disappearance time of eyelash reflex,operation time,dosage of propofol,recovery time,recovery time of directional force]and incidence of adverse reactions during perioperative anesthesia were compared between the two groups.Results MAP and HR in the observation group were higher than those in the control group(P<0.05).The VAS scores at the moment of postoperative recovery,15,30 and 60 min in the observation group were lower than those in the control group(P<0.05).The disappearance time of eyelash reflex,recovery time and orientation recovery time in the observation group were shorter than those in the control group,and the dosage of propofol was less than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was 22.50%,which was lower than 44.50%in the control group(P<0.05).Conclusion:Low-dose es ketamine can effectively improve the effect of painless induced abortion anesthesia,help to stabilize hemodynamics and reduce postoperative uterine pain,and has good safety.

关 键 词：无痛人流 麻醉 艾司氯胺酮 血流动力学 宫缩痛 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]