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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1~1.5 mg/kg;KF组采用氯胺酮0.1 mg/kg+芬太尼1μg/kg+异丙酚1~1.5 mg/kg。若两组病人出现不自主肢体活动时追加异丙酚0.2~0.4 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 investigate the effects and adverse reactions of low-dose ketamine and fentanyl combined with propofol for painless abortion. Methods: Ninety cases of early pregnancy induced abortion with ASA Ⅰ ~ Ⅱ were randomly divided into F group and KF group. Fentanyl 1μg / kg + propofol 1 ~ 1.5 mg / kg in group F and ketamine 0.1 mg / kg + fentanyl 1μg / kg + propofol 1 ~ 1.5 mg / kg in KF group. If two groups of patients with involuntary physical activity when appending propofol 0.2 ~ 0.4 mg / kg. Preoperative and intraoperative mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO2), total propofol consumption, adverse reactions and patient wakefulness, walking recovery time and departure time were recorded. Results: Compared with F group, the inhibition of MAP and SpO2 was reduced in KF group and the dosage of propofol was decreased. The awake time, walking recovery time and hospitalization time of patients in KF group were shorter than those in F group, and the adverse reactions decreased. Conclusion: Low dose ketamine, fentanyl combined with propofol for painless flow can achieve good analgesic effect, can reduce the dosage of 3 kinds of drugs and reduce the adverse reactions of drugs.