小剂量氯胺酮复合丙泊酚在人工流产术中的应用研究

目的：观察阁下剂量氯胺酮复合丙泊酚在人工流产术中的效能及安全性。方法：将100例病人随机分成两组，A组为氯胺酮复合丙泊酚组，B组为单纯丙泊酚组。两组病人均为ASAI级，病情、孕期无差异。两组病人常规术前准备，开通静脉，静注阿托品0．5nag。A组术前静注丙泊酚2mg／kg（30s）及氟胺酮0．5mg／kg，术中根据患者躁动情况追加丙泊酚1mg／kg。B组静注相同剂量丙泊酚。分别记录丙泊酚的用量、术中的SpO2、BP、HR、病人躁动情况、清醒时间及术后患者VAS评分。结果：用上述麻醉方法，两组病人均能顺利完成手术。A组丙泊酚平均用量为2．5mg／kg，个别患者需要追加，均未出现呼吸抑制，SpO2 92～99％，HR60～902K／min，术中BP稳定，5例发生躁动（10％），追加丙泊酚后平静，术毕清醒时间为11min。B组丙泊酚用量为4．5mg／kg，术中均需要追加丙泊酚，均无呼吸抑制，SpO2最低93～99％。HR60～1303次／min，以操作时增快明显，BP均有不同程度的增加，躁动25例（50％），术毕VAS评分两组病人均为0，清醒时间为12min。结论：阈下剂量氯胺酮（0．5ms／kg）复合丙泊酚在人工流产术中具有高度的安全性，比单一使用丙泊酚更平稳，清醒同样彻底和快速。

Application of Minor Dose Ketamine Combined with Propofol in Abortion

Objective ： To study the effect and safety of subliminal dose ketamine combined with propofol in abortion. Method： 100 cases of patients aborted artificially were randomly divided into two groups： ketamine combined with propofol group （ group A ） and propofol group （ group B ）. Two groups of patients were ASA 1 , had no difference in patient＇ s condition and trimester, and were preoperational prepared regularly, established vein path, intravenous injection of atropin O. 5mg. GroupA was treated with intravenous injection of propofol 2mg/kg and ketamine O. 5mg/kg preoperational, intravenous injection of propofol 1mg/ kg according to the impetuous patients during the operation. Group B treated with intravenous injection of the same dose propofol. Dose of propofol, SPO2 , BP, HR, restlessness during the operation, awaken time and VAS score after operation were observed. Result： All of patients were finished the operations smoothly. In group A, the mean dosage of propofol was 2.5mg/kg, someone need supplement, no respiratory depression occurred, with SPO2 92 - 99%, HR 60 - 90bpm, stable BP, 5 cases had impetuous （ 10% ） , became calm after treated with supplemental propofol, the mean awaken time was 11 minutes. In group B, the mean dosage of propofol was 4.5mg/kg, all need supplement, no respiratory depression occurred, with SPO2 93 99%, HR 60 - 130bpm, increasing significantly when supplement, with BP increased, 25 cases bad impetu- ous （50%）, ,he mean awaken time was 12 minutes. VAS score of two groups were 0. Conclusion： Using subliminal dose ketamine （0.5mg/kg） combined with propofol in abortion has the advantage of more safety than using single propofol, and awaken quickly and thoroughly as same as the latter.