三种静脉麻醉药用于人工流产的麻醉效果观察

Observation on the Anesthetic Effect of 3 Intravenous Anesthetics in Artificial Abortion

目的研究双异丙酚联合芬太尼,氯胺酮在人工流产中的镇痛效果,副反应,寻求最佳静脉药物配伍方法.方法选择ASAⅠ～Ⅱ级人流患者800例,随机分为四组:Ⅰ组200例为对照组;Ⅱ、Ⅲ、Ⅳ组各200例为观察组.对照组不用镇痛及麻醉药,Ⅱ组静注双异丙酚2mg/kg;Ⅲ组静注双异丙酚2mg/kg+芬太尼1μg/kg;Ⅳ组静注双异丙酚2mg/kg+氯胺酮0.3mg/kg.匀速30～40秒推注.观察三组患者诱导及苏醒时间、镇痛效果、副反应.结果观察组三组均麻醉起效快,镇痛效果确切,有效率100%,与对照组相比差异有显著性(P＜0.01).副反应中最明显的人流综合症(PAAS)观察组无1例发生.对照组发生率为38.5%,两组对比差异有显著性(P＜0.01).结论双异丙酚,双异丙酚+芬太尼,双异丙酚+氯胺酮用于人流均可达无痛的良好效果,且副反应明显减少,可广泛推广应用,但必须严密监测,观察呼吸、循环以保证安全.

Objective To study the pain relief and side effect of the combination of disopmfol, fentanyl and ketamine in artificial abortion so as to find out the best compatability of intravenous anesthetics. Methods 800 cases were selected and randomly divMed into 4 groups： one control group and three observing groups, each group had 200 cases. The control group was given no anesthetics. Group Ⅱ was given disoprofol 2mg/kg by intravenous injection while Group Ⅲ disoprofol 2mg/kg plus fentanyl 1μg/ kg and Group Ⅲ disoprofol 2mg/kg plus ketamine 0.3mg/kg.All the injection finished within 30 ～ 40 seconds and at even speed. Then, the induction, the time for awaking, pain-relieving effect and sMe effect of the three observing groups were observed. Results Rapid anesthetic effect and conformed pain-relieving effect were found in the three observing groups, and the effective rate reached 100% ,which was significantly different from that of the control group （ P 〈 0.01 ）. Conclusions Intravenous anesthetics with disporofol,or with disoprofol and fentanyl,or with disoprofol and ketamine,can well relieve pain and reduce side effect obviously in artificial abortion, it is worthy of wide application while close monitoring of respiration and circulation is given for safety.