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目的:评价人工流产术患者不同剂量氯胺酮复合异丙酚麻醉的效应。方法:择期行人工流产术患者160例,分为对照组(C组)(诱导时静脉注射异丙酚2 mg/kg);Ⅰ组(诱导时静脉注射异丙酚2 mg/kg及氯胺酮0.1 mg/kg);Ⅱ组(诱导时静脉注射异丙酚2 mg/kg及氯胺酮0.2 mg/kg);Ⅲ组(诱导时静脉注射异丙酚2 mg/kg及氯胺酮0.3 mg/kg),每组40例。患者意识消失后开始手术,出现体动反应追加异丙酚30~50 mg,分别记录诱导前(患者入室稳定3m in后)、扩宫口、宫腔负压吸引时及术毕时平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)及手术时间、意识消失时间(从开始注药至意识消失时间)、意识恢复时间(停止注药至呼之睁眼时间)、异丙酚用量及注射时疼痛情况并评价麻醉满意度。结果:各组患者年龄、体重、手术时间差异无统计学意义。与C组相比,Ⅰ组、Ⅱ组、Ⅲ组注药时疼痛例数减少,异丙酚用量降低,麻醉满意率提高(P<0.05),Ⅱ组与Ⅲ组间差异无统计学意义(P>0.05),但Ⅲ组苏醒时间明显延长(P<0.05)。与诱导前相比,扩宫口、宫腔负压吸引时各组平均动脉压(MAP)均降低;但Ⅱ组和Ⅲ组明显高于C组(P<0.05)。结论:异丙酚2 mg/kg复合氯胺酮0.2 mg/kg可显著提高人工流产术患者麻醉满意率且无不良反应发生。
OBJECTIVE: To evaluate the effect of different doses of ketamine combined with propofol anesthesia in patients undergoing abortion. Methods: A total of 160 patients undergoing elective abortion were divided into control group (group C) (intravenous injection of propofol 2 mg / kg on induction); group I (propofol 2 mg / kg and ketamine 0.1 (iv, propofol 2 mg / kg and ketamine 0.2 mg / kg); group Ⅲ (intravenous propofol 2 mg / kg and ketamine 0.3 mg / kg on induction) Group of 40 cases. After the patient’s consciousness disappeared, the operation was started. The body movement reaction was supplemented with 30-50 mg of propofol, and the mean arterial pressure (MAP) at the time of induction of uterine cavity expansion, (MAP), heart rate (HR), pulse oxygen saturation (SpO2), operation time, disappearance of consciousness (time from the beginning of injection to consciousness disappearance), consciousness recovery time The amount of propofol and pain at the time of injection and evaluation of anesthesia satisfaction. Results: There was no significant difference in age, weight and operation time between the two groups. Compared with group C, the number of pain cases in group Ⅰ, group Ⅱ and group Ⅲ decreased, the dosage of propofol decreased, the satisfaction rate of anesthesia increased (P <0.05), and there was no significant difference between group Ⅱ and group Ⅲ P> 0.05), but the recovery time of group Ⅲ was significantly longer (P <0.05). Compared with the pre-induction, the mean arterial pressure (MAP) in the uterine cavity and the uterine cavity decreased when the uterus was suctioned, but the levels in group Ⅱ and group Ⅲ were significantly higher than those in group C (P <0.05). Conclusion: Propofol 2 mg / kg combined with ketamine 0.2 mg / kg can significantly improve the rate of anesthesia satisfaction and no adverse reactions in induced abortion.