不同小剂量氯胺酮复合丙泊酚用于人工流产手术的临床观察

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1、日——固■譬■_论著China&ForeignMedicalTreatment不同小剂量氯胺酮复合丙泊酚用于人工流产手术的临床观察周桃钰汪辉陈金保安徽省铜陵市人民医院麻醉科．安徽铜陵244000【摘要】目的探讨不同小剂量氯胺酮复合丙泊酚在人工流产手术中的麻醉镇痛效果及其安全、有效性。方法选择120例ASAI～Ⅱ级，妊娠6～9周且自愿终止妊娠孕妇，随机分成4组。A组(对照组)静注生理盐水5mL，1min后静注丙泊酚2mg／kg；B组静注氯胺酮0．2ms／ks、丙泊酚1．5-2mg／kg；C组静注氯胺酮0．3mg／kg、丙泊酚1．5～2mg／k

2、g；D组静注氯胺酮0．4mg／kg、丙泊酚1．5-2mg／kg。观察术中各组SBP、DBP、HR、SpO：的变化及麻醉效果、术后镇痛效果，记录各组丙泊酚用药总量、清醒时间、离院时间及术后恶心、呕吐等并发症。结果术中丙泊酚总用量A、B两组明显多于C、D组(P<0．05)；术后清醒时间D组明显长于A组(尸l<0．05)，离室时间4组差异无统计学意义。A、B两组丙泊酚诱导后2minSBP、DBP、HR与诱导前有显著差异(P<0．05)，C、D两组麻醉过程中心率、血压比较平稳。B、C、D3组麻醉、镇痛效果明显优于A组，术后恶心反应也少于A组(P<0

3、．05)。结论小剂量氯胺酮与丙泊酚合用于人工流产手术，麻醉镇痛效果好，并发症少，0．3rag／ks氯胺酮与丙泊酚复合应用尤为安全、有效。【关键词】氯胺酮；丙泊酚；人工流产【中图分类号】R169【文献标识码】A[文章编号】1674—0742(2013)12(a)一0005—03ClinicalObservationonDi馑erentSmanDosesofKetamineCombinedwithPropofolAppliedtoInducedAbortionZHOUTaoyuWangHuiCHENJinbaoDepartmentofAnest

4、hesiology，ThePeople"sHospitalofTongling，AnhuiProvince，Tongling，AnhuiProvince，244000，China[Abstract]ObjectiveTostudytheanesthesiaefect，safetyandefectivenessofdiferentsmalldosesofketaminecombinedwithpropofolappliedtoinducedabortion．Methods120casesofpregnantwomenundergoingvol

5、untaryterminationofpregnancywithagestationalageof6~9weeks，ASAI～IIlevel，wereselectedandrandomlydividedinto4groups．Byintravenousinjection，saline5ml，thenpropofol2mg／kgafter1minweregiventogroupA(controlgroup)，ketamine0．2ms／kSandpropofol1．5-2mg／kgweregiventogroupB，ketamine0．3mg

6、／kgandpropofol1．5~2mg&gweregiventogroupC，andketamine0．4rag／ksandpropofol1．5—2mg／kgweregiventogroupD．EachgroupsintraoperativechangesofSBP，DBP，HR，Sp02,anestheticefectandpostoperativeanalgesiawereobserved，andthetotalamountofpropofoladministration，timeofconsciousness，timeofdis

7、charge，postoperativenausea，vomitandothercomplicationswererecorded．ResultsTheintraoperativetotalamountsofpropofolusedingroupAandgroupBweresignificantlymorethanthoseusedingroupCandD(P<0．05)．ThetimeofconsciousnessingroupDwasobviouslylongerthanthatingroupA(P<0．05)．Butnosignifi

8、cantdiferencebetweenfourgroupsintimeofdischarge．ForgroupAandgroupB，thereweresignificantly