复合小剂量氯胺酮用于无痛人工流产术的观察

目的 探讨小剂量氯胺酮对阿片类药物复合丙泊酚用于人工流产术的影响.方法 选择自愿要求行无痛人工流产术,ASA Ⅰ～Ⅱ级,无麻醉及手术禁忌证的女性患者80例,按随机原则分为4组：A组（SP组,舒芬太尼0.1 μg/kg复合丙泊酚1.5 mg/kg） 26例,B组（RP组,瑞芬太尼1μg/kg复合丙泊酚1.5 mg/kg）19例;C组（KSP组,微小剂量氯胺酮2 mg与舒芬太尼0.1 μg/kg复合丙泊酚1.5 mg/kg）17例;D组（KRP组,微小剂量氯胺酮2 mg与瑞芬太尼1μg/kg复合丙泊酚1.5 mg/kg）18例.记录患者的年龄、体重,手术前患者心率（HR）、血压（SBP）、脉搏血氧饱和度（SpO2）,手术中患者HR、SBP、SpO2、体动及呼吸抑制的发生次数,手术后患者HR、SBP、SpO2及清醒时间和用药总量.结果 各组术前与术中HR、术前与术中SBP、术前与术后HR的差异有统计学意义;术前与术后SBP的差异无统计学意义.SP组与RP组术中SBP、术后SpO2、呼吸抑制的发生率的差异有统计学意义.SP组与KSP组清醒时间差异有统计学意义.RP组与KRP组清醒时间差异有统计学意义.KSP组与KRP组术中SBP、体动的发生率的差异有统计学意义.结论 在门诊无痛人工流产手术中,使用小剂量氯胺酮能使患者术后更快地清醒.

Observation of combined small dose ketamine on painless induced abortion

Objective To explore the influence of small dose ketamine on artificial abortion operation together with o- pioid and propofol. Methods 80 patients voluntarily requested painless induced abortion were selected at the premise of ASA being in grade Ⅰ -Ⅱ and no anesthetic or surgical eontraindications. They were randomly divided into 4 groups： group A （group SP, 0.1 μg/kg sufentanil combining with 1.5 mg/kg propofol,n=26）, group B （group RP, 1 μ g/ kg remifentanil combining with 1.5 mg/kg propofol,n=19）, group C （group KSP, 2 mg ketamine and 0.1 pog/kg sufen- tanil combining with 1.5 mg/kg propofol,n=17）, and group D （group KRP, 2 mg ketamine and 1μg/kg remifentanil combining with 1.5 mg/kg propofol,n=18 ）. The patient＇s age, weight, preoperative heart rate （HR）, preoperative blood pressure （SBP）, preoperative pulse oxygen saturation （SpO2）, intraoperative HR, SBP, SpO2 and times of body move- ment and respiratory depression, and postoperative HR, SBP, SpO2, and awaking time and total amount of drugs were all recorded. Results There were statistical differences in HR, SBP before and during surgery, and HR betbre and after surgery among 4 groups. The SBP before and after surgery didn＇t show significant differences among 4 groups. The in- traoperative SBP, postoperative SpO2, and incidence of respiratory depression in group SP and group RP displayed sta- tistical differences. In group SP and group KSP, there was a statistical difference in awaking time, while in group RP and KRP, there was no significant difference. The intraoperative SBP and incidence of body movement displayed sta- tistical differences in both group KSP and group KRP. Conclusion In outpatient painless induced abortion, the appli- cation of small dose ketamine can shorten the awaking time for patients after surgery.