几种不同镇痛方法在人工流产术中的应用

Discussion on Varied Analgesia Methods during Artificial Abortion

目的观察人工流产中镇痛方法的临床效果,探讨一种安全、有效、简便,可供选择的无痛人流方法。方法250例终止妊娠者随机分为异丙酚组、氯胺酮组、笑气组、宫颈旁阻滞组、对照组。观察总结了手术中镇痛效果、术后恢复等情况,以及静脉麻醉组对呼吸循环的影响等。结果静脉麻醉组镇痛完全(P<0.01),无人流综合征发生。局部用药组均不能完全消除疼痛及人流综合征的发生。异丙酚组对呼吸循环有一过性抑制作用(P<0.05),氯胺酮组苏醒时间长(P<0.01),苏醒时大多有不良反应发生(P<0.01)。结论各种镇痛方法在人工流产中均有一定的镇痛作用,根据镇痛效果、苏醒时间、宫颈松弛及人流术后综合征等情况,由优到劣,依次为异丙酚组、氯胺酮组、笑气组、宫颈旁阻滞组、对照组。

Objective To observe the curative effect of varied analgesia methods during artificial abortion to find a safe, simple and effective method. Methods 250 cases of such patient were divided into propofol group, ketamine group, nitrous oxide group, cervical blockage group and control group. The analgesia effect, postoperative recovery affection of respiration and circulation in venous group were observed. Results The analgesia was completed in venous group without cornplication（ P 〈 0.05）. The local anesthesia could not decrease pain and complication. There was some inhibition of respiration in propofol group （ P 〈 0.05）. The recovery time was longer in ketamine group with side effect. Conclusion There might be some effect in varied groups. The sequence of effect in analgesia, recovery time, relax of cervix and complication from better to worse should be propofol group, ketamine group, nitrous oxide group, cervical blockage group and control group.