丙泊酚—利多卡因—氯胺酮用于无痛人流的临床观察

目的:比较5种不同麻醉方法行无痛人流的麻醉效果,探讨丙泊酚—利多卡因—氯胺酮用于无痛人流的可行性。方法:200例早孕妇女随机分为5组:Ⅰ组为单纯丙泊酚,Ⅱ组为利多卡因—丙泊酚,Ⅲ组为芬太尼—丙泊酚,Ⅳ组为氯胺酮—丙泊酚,Ⅴ组为氯胺酮—利多卡因—丙泊酚。观察并记录丙泊酚用量、清醒时间、离院时间、麻醉前、麻醉后每2min的BP、HRs、PO2及术中、术后不良反应。结果:Ⅰ、Ⅱ组用药量高于其它三组(P<0.01);Ⅰ、Ⅱ、Ⅲ组病人BP、HRs、PO2均明显下降(P<0.05),以Ⅲ组最为明显(P<0.01)。清醒时间及离院时间,Ⅳ组长于其它4组(P<0.05)。局部注射痛发生率Ⅰ组高于Ⅲ组,Ⅲ组高于Ⅳ组,Ⅳ组高于Ⅱ组,而Ⅴ组无注射痛发生。结论:异丙酚—利多卡因—氯胺酮用于无痛人流术较为安全可靠。

Clinical Observation of Painless Abortion Induced by Propofol- Lidccaine- Ketmnine

Objective:To compare anesthesia effects of painless abortion with five different kinds of anesthesia methods and to explore the feasibility of propofol-Lidocaine-Ketamine used for painless abortion.Methods: 200 early pregnant women were devided randomly into five groups:(Ⅰ)propofol alone,(Ⅱ) lidocaine-propofol,(Ⅲ)fentanyl-propofol,(Ⅳ) ketamine-propofol,(Ⅴ)ketamine-lidocaine-propofol.The consumption of propofol,recovery time,departure time,BP,HR,sPO_2 at per 2 min before and after anesthesia,as well as the adverse reaction of operation were observed and recorded.Results: Among five groups of patients,the consumption in group(Ⅰ)(Ⅱ) was higher than that in other three groups(P<0.01),the levels of BP、HR、sPO_2 of patients was significantly decreased in groupⅠ,Ⅱ and Ⅲ(P<0.05),the decrease of group Ⅲ was the most significant(P<0.01).Recovery time and departure time in group IV was longer than that in the other four groups(P<0.05).About the incidence of local injection pain,groupⅠ was higher than groupⅢ,and groupⅢ higher than group Ⅳ;group Ⅳ higher than GroupⅡ;but local injection pain didn't occur in group Ⅴ.Conclusion: Propotol-Lidocaine-Ketamine used for painless abortion is safer and more reliable.