不同配伍的异丙酚静脉麻醉在人工流产及宫腔镜检查中的应用

The apply of different compatibility of propofol used for intravenous anesthesia in induced abortion and uteroscope examine

目的 :观察异丙酚与芬太尼、氯胺酮、曲马多复合麻醉用于无痛人流和宫腔镜检查的效果 ,探讨合理的麻醉配方。方法 :90例行无痛人流和宫腔镜检查的患者 ,随机分为 3组 ,异丙酚分别复合芬太尼 (F组 )、氯胺酮(K组 )及曲马多 (T组 )静脉麻醉 ,每组 30例。观察各组异丙酚用量、意识消失时间、停药后清醒时间、清醒后独立离院时间 ;监测Bp、HR、SpO2 、术中及术后的不良反应。结果 :异丙酚用量三组间无显著性差异。K组意识消失时间短 (P <0 .0 5 ) ;F组清醒时间和离院时间长 (P <0 .0 5 )。F组SpO2 下降幅度及下降率高 (P <0 .0 1) ;低血压、心率减慢发生率高于K、T组 (P <0 .0 5 ,P <0 .0 1)。F组术后站立眩晕率高 (P <0 .0 5 ) ;3组均有个别患者发生恶心、腹痛及欣快感 ,无尿潴留及皮肤瘙痒发生。结论 :异丙酚与芬太尼、氯胺酮、曲马多复合麻醉用于无痛人流和宫腔镜检查 ,镇痛效果均好。但氯胺酮 异丙酚和曲马多 异丙酚诱导和清醒更加迅速 ,呼吸循环抑制轻 ,不良反应未见增加 。

Objective:To observe the effect of propofol anesthesia with fentanyl,kentamine,tramadol in artifician abortion and Hysteroscope Examine.Methods:Ninety patiens were randomly divided into three groups with 30 cases each: Propofol compound fentanyl(group F), kentamine(group K) and tramadol(group T) intravenous anesthesia separately.The propofol dosage,consciousness loss time, wake-up time,independenly leave hospital time were recorded. Observing Bp,HR, SpO 2 and side effects during intro-and post-operative. Results:The dosage of propofol in three groups wasn's significant difference. Consciousness loss time in group K was shorter(P<0.05), wake-up time and independenly leave hospital time were longer in group F than that in the others(P<0.05). SpO 2 down range and rate were significant higher in group F (P<0.01). Bp and HR decrease were significant higher in group F (P<0.05, P<0.01). Postoperative vertigo was higher in group F(P<0.05). The incidences of nausea ,bellyache and euphoria were low in three groups.Conclusion:The analgesic effects are all good in three groups that compound anesthesia of propofol .But propofol- kentamine and propofol- tramadol are more rapidly in inducement and recovery without significant side effects ,they are safe and suitable choice in artifician abortion and Uteroscope Examine.