新疆医科大学学报

目的:探讨小剂量氯胺酮、芬太尼复合异丙酚用于无痛人流的效果及不良反应。方法:选择ASAⅠ~Ⅱ级行人工流产的早孕患者90例,随机分为F组与KF组。F组采用芬太尼1μg/kg+异丙酚1¹.5 mg/kg;KF组采用氯胺酮0.1 mg/kg+芬太尼1μg/kg+异丙酚1¹.5 mg/kg。若两组病人出现不自主肢体活动时追加异丙酚0.2⁰.4 mg/kg。记录术前和术中平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)值、异丙酚总用量、不良反应及病人清醒时间、行走恢复时间和离院时间。结果:KF组与F组比较,MAP、SpO2抑制减轻,异丙酚用量减少,病人的清醒时间、行走恢复时间及离院时间均缩短,且不良反应减少。结论:小剂量氯胺酮、芬太尼联合异丙酚用于无痛人流能达到良好的镇痛效果,能降低3种药物用量,减少药物的不良反应。

Objective: To reach the effect and adverse effect of propofol combined with low-dose ketamine and fentanyl used in artificial abortion operation and to compare the effect with the same dose of fentanyl.Method: Ninety ASAⅠ～Ⅱ early pregnant women undergoing artificial abortion were randomly divided into 2 group with 45 patient in each group.Patients in group F was administrated fentanyl 1 μg/kg and propofol 1¹.5 mg/kg before the operation;Patients in group KF was administrated ketamine 0.1 mg/kg,fentanyl 1 μg/kg and propofol 1¹.5 mg/kg before the operation.If patients were observed movement in the operation,we administrated propofol 0.2～0.4 mg/kg again.MAP,HR,SpO₂,total dose of propofol,adverse effect,the time of arousal and the time of movement were recorded.Results: In group F,MAP,SpO₂ inhibited significantly and total dose of propofol and adverse effect increased significantly as compared to arousal(P<0.05).In group KF,the time of arousal and movement also short significantly as compared to group F(P<0.05).Conclusion: In artificial abortion operation,the combination of low-dose ketamine,fentanyl and propofol can maintain better anesthetic effect,decrease the dose and adverse effect of anesthetics.