艾司氯胺酮复合丙泊酚在无痛人流术中的应用  

Clinical Application of Esketamine Combined with Propofol in Painless Abortion

作　　者：张宁丽 周臣[1] 思永玉[1] 欧阳杰[1] 林岚[1] 陈莹[1] 牛钦 李鸿[1] ZHANG Ningli;ZHOU Chen;SI Yongyu;OUYANG Jie;LIN Lan;CHEN Ying;NIU Qin;LI Hong(Dept.of Anesthesia,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院麻醉科,云南昆明650101

出　　处：《昆明医科大学学报》2023年第5期102-106,共5页Journal of Kunming Medical University

基　　金：云南省科技厅科技计划基金资助项目(202101AY070001-149)。

摘　　要：目的探讨艾司氯胺酮复合丙泊酚在无痛人流术中应用的优势。方法选取昆明医科大学第二附属医院行无痛人工流产术的患者50例,随机分为对照组和观察组,每组25例。对照组(F组):芬太尼复合丙泊酚静脉麻醉;观察组(S组):艾司氯胺酮复合丙泊酚静脉麻醉。分别记4个时间点的HR、MAP和SpO_(2);记录2组患者意识消失时间、意识恢复时间、手术时长、丙泊酚使用剂量;记录2组患者术中体动发生率、注射痛发生率、循环抑制和呼吸抑制发生情况、术后不良反应发生率和术后疼痛评分(VAS评分)。结果2组患者手术时长、丙泊酚使用剂量、VAS评分、苏醒时间比较,差异无统计学意义(P>0.05);在T3时刻,F组患者MAP、HR、SpO_(2)低于S组(P<0.05);2组患者注射痛发生率、术后头晕、恶心、呕吐发生率比较,差异无统计学意义(P>0.05);S组患者体动、呼吸、循环抑制发生率低于F组(P<0.05);S组患者不良反应总发生率低于F组(P<0.05)。结论艾司氯胺酮复合丙泊酚静脉麻醉能够安全有效的运用于无痛人流术,同时能减少术中体动、呼吸和循环抑制、降低术后不良反应的发生率,维持术中血流动力学稳定。Objective To explore the advantages of esketamine combined with propofol in painless abortion.Methods 50 patients who underwent the painless abortion were selected and randomly divided into the control group and the observation group,with 25 in each group.The control group received Fentanyl combined with propofol intravenous anesthesia while the observation group received Esketamine combined with propofol intravenous anesthesia and the HR,MAP and SpO_(2) before the induction(T1),immediately after the operation(T2),3 min after the operation(T3)and immediately after the operation(T4)was recorded respectively.The time of consciousness loss and recovery,operation duration and dosage of propofol were recorded.The intraoperative body motor reaction,propofol injection pain,circulation depression,respiratory depression,postoperative adverse reactions and postoperative pain were scored(VAS score).Results The comparison of the operation time,propofol dose,VAS score and recovery time between the two groups proved to be statistically insignificant(P>0.05).At T3,MAP,HR,and SpO_(2) in the control group were lower than those in the observation group(P<0.05);The incidence of injection pain,postoperative dizziness,nausea,and vomiting between the two groups proved to be statistically insignificant(P>0.05).The incidence of body movement,respiration,and circulation depression in the observation group was lower than that in the control group(P<0.05);The overall incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion The application of esketamine combined with propofol in TIVA for painless abortion has been proved to be safe and feasible,and can reduce the incidence of intraoperative body motor reaction,respiratory circulation inhibition and other adverse reactions,and maintain the stability of intraoperative hemodynamics.

关 键 词：艾司氯胺酮 丙泊酚 无痛人工流产术 静脉麻醉 

分 类 号：R614.2[医药卫生—麻醉学]