无痛人工流产术艾司氯胺酮复合丙泊酚与舒芬太尼复合丙泊酚麻醉效果对比  

Comparison of the anesthetic effect of esketamine combined with propofol and sufentanil combined with propofol used during painless abortion

作　　者：杨丽华[1] 王莹[1] 李军仕 李新锋[1] YANG Lihua;WANG Ying;LI Junshi;LI Xinfeng(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province,450052)

机构地区：[1]郑州大学第一附属医院,450052

出　　处：《中国计划生育学杂志》2024年第5期1022-1026,共5页Chinese Journal of Family Planning

基　　金：河南省卫生健康委员会项目(SBGJ202102080)。

摘　　要：目的:对比艾司氯胺酮复合丙泊酚与舒芬太尼复合丙泊酚在无痛人工流产中的麻醉效果。方法:随机数字表法将2023年2月-2023年10月在本院行无痛人工流产术女性102例分为舒芬太尼组(舒芬太尼0.1μg/kg复合丙泊酚2.0mg/kg,n=51)和艾司氯胺酮组(艾司氯胺酮0.2mg/kg复合丙泊酚2.0mg/kg,n=51)。比较两组不同时点[麻醉诱导前(T0)、给药后1min(T1),给药后3min(T2),意识消失时(T3)、手术开始时(T4)、手术结束时(T5)]血流动力学指标、围手术期指标、苏醒后宫缩疼痛程度、不良反应。结果:艾司氯胺酮组T3、T4、T5时舒张压、收缩压、平均动脉压、心率水平均高于舒芬太尼组,T4时血氧饱和度高于舒芬太尼组,丙泊酚总用量(121.33±12.48mg/kg)、意识消失时间(32.59±3.87s)小于舒芬太尼组(150.49±14.26mg/kg、37.06±4.52s),视觉模拟评分法(VAS)苏醒后15min(2.75±0.36分)、30min(3.15±1.02分)均低于舒芬太尼组(3.69±0.58分、4.48±1.59分),不良反应发生率(13.7%)低于舒芬太尼组(31.4%)(均P<0.05)。结论:无痛人工流产术中,艾司氯胺酮复合丙泊酚具有比舒芬太尼复合丙泊酚更好的麻醉效果,能够有效维持受术女性血流动力学稳定,减少丙泊酚使用剂量,减轻术后宫缩疼痛程度,且不良反应少,安全性高。Objective:To compare the anesthetic effect of esketamine combined with propofol and sufentanil combined with propofol used during painless abortion.Methods:A total of 102women who wanted painless abortion were divided into two groups(51cases in each group)according to random number table method from February 2023to October 2023.The women in group A were given sufentanil 0.1μg/kg combined with propofol 2.0mg/kg for anesthesia during painless abortion,and the women in group B were given esketamine 0.2mg/kg combined with propofol 2.0mg/kg for anesthesia during painless abortion.The values of hemodynamic indexes,perioperative indexes,pain degree of contraction after recovery and the occurrence of adverse reactions of the women were compared between the two groups at different time points[before anesthesia induction(T0),at 1min after administration(T1),at 3min after administration(T2),when consciousness disappeared(T3),at the beginning of surgery(T4),at the end of surgery(T5)].Results:The values of diastolic blood pressure,systolic blood pressure,mean arterial pressure and heart rate of the women in group B at T3,T4and T5were significantly higher than those of the women in group A,and the blood oxygen saturation value of the women in group B at T4was significantly higher than that of the women in group A.The total dosage of propofol(121.33±12.48mg/kg)and the time of loss of consciousness(32.59±3.87s)of the women in group B were significantly lower than those(150.49±14.26mg/kg and 37.06±4.52s)of the women in group A.The score of visual analogue scale(VAS)of the women in group B at 15minutes(2.75±0.36points)and at 30minutes(3.15±1.02 points)after awakening were significantly lower than those(3.69±0.58points and 4.48±1.59points)of the women in group A,and the incidence of adverse reactions(13.7%)of the women in group B was significantly lower than that(31.4%)of the women in group A(all P<0.05).Conclusion:Esketamine combined with propofol used during the painless abortion of the women has better anesthetic effect

关 键 词：无痛人工流产术 艾司氯胺酮 舒芬太尼 丙泊酚 麻醉镇痛效果 不良反应 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]