不同种类麻醉剂在人工流产术中的应用

The application of different kinds of anesthetic to artificial abortion

目的 研究不同种类的麻醉剂在人工流产术中的麻醉镇静镇痛作用及其对呼吸、循环的影响 ,试图寻找一种安全有效的麻醉用药方案。方法 16 0例年龄 35岁以下妊娠 7周内、自愿接受人工流产手术的孕妇随机分为A、B、C、D 4组 ,A组为对照组 ,B、C、D为观察组 ;B组静脉注射氯胺酮 0 7mg kg,C组静脉注射氯胺酮 0 5mg kg+咪唑安定 0 0 5mg kg ,D组静脉注射丙泊酚 2 5mg kg。记录术前、术中呼吸 (HR)、血压(BP)、血氧饱和度 (SPO2 )变化 ;观察术中术后有无呻吟、体动、出汗、谵语、恶心、呕吐及麻醉后清醒时间、离院时间等。结果 3组麻醉剂在人工流产术中都有肯定的麻醉镇静和镇痛效果 ,并能有效的预防人工流产综合征的发生 ,其中又以氯胺酮 +咪唑安定组镇痛效果优且副反应少。结论 氯胺酮 +咪唑安定静脉麻醉为人工流产术的理想麻醉方法。

Objective To investigate sedation and analgesic effect of different anesthetic methods during artificial abortion, and their influence on respiration and circulation, and to find a efficient and safety method of anesthesia. Methods Of their own wills of receiving artificial abortion, 160 women under 35 years old within seven pregnant weeks were divided into four groups randomly.Group A served as control without any anesthesia.Group B were given ketamine 0.7 mg/kg intravenously; Group C ketamine 0.5 mg/kg and midazolam 0.05 mg/kg; Group D propofol 2.5 mg/kg.The changes of HR, BP and SPO 2 before and during operation were recorded.Any groan, body movements, sweating, delirium, nausea and vomiting during and after operation were observed, as well as recovery time after anesthesia and hospitalized duration. Results All the three anesthetic methods presented certain analgesia and anesthetic effect, moreover, artificial abortion syndrome could be prevented as well.The group of ketamine and midazolam resulted in better effect and fewer side effects than the other two groups. Conclusions Intravenous ketamine and midazolam is one of ideal anesthetic methods to easy pain in artificial abortion.