丙泊酚复合酮咯酸氨丁三醇麻醉用于无痛人工流产手术患者的临床效果

Outcomes of propofol combined with ketorolac tromethamine used in painless induced abortion

目的探讨丙泊酚复合酮咯酸氨丁三醇麻醉用于无痛人工流产(人流)手术患者的临床效果。方法无痛人流手术患者180例,随机均分为三组,采用丙泊酚中/长链脂肪乳注射液分别复合酮咯酸氨丁三醇30mg(麻醉诱导前30min静脉注射,A组)、雷米芬太尼(B组)或氯胺酮(C组)麻醉。记录麻醉前、麻醉后患者的MAP、HR、RR、SpO_2。观察术中呼吸抑制和术中肢动发生情况;计算丙泊酚用量及意识恢复时间;术后询问患者对手术操作过程有无记忆和术毕30min有无宫缩痛。结果三组患者镇痛均满意。A、C两组术中MAP、HR、RR、SpO_2平稳;B组术中MAP、HR、RR、SpO_2均低于麻醉前(P<0.05)。A组患者无术中一过性呼吸抑制,亦无术后宫缩痛病例;B组患者术中均有一过性呼吸抑制,术后宫缩痛45例(75%),C组仅有2例(3%)发生一过性呼吸抑制。C组术毕意识恢复时间长于A、B两组[(15.21±0.97)min vs.(7.19±1.05)min、(7.11±1.04)min](P<0.05)。结论丙泊酚复合酮咯酸氨丁三醇用于无痛人流手术是一种良好的选择。

Objective To observe the clinical efficacy of propofol combined with ketorolac tromethamine in painless induced abortion.Methods A total of 180 outpatients undergoing painless induced abortion was intravenously injected with propofol（middle-long chain emulsion injection）combined with ketorolac tromethamine 30 mg at 30 minutes before anesthesia（group A,60cases）,remifentanil（group B,60cases）or ketamine（group C,60cases）,respectively.The MAP,HR,RR and SpO2 were recorded continuously.The incidence of respiratory depression and limb movements during operation was recorded.The consumption of propofol and the time for the recovery of consciousness from anesthesia were calculated.The intraoperative awareness and postoperative uterine contraction pain were followed up.Results Analgesia was all satisfactory in three groups.The MAP,HR,RR and SpO2 were stable intraoperatively in groups of A and C,which were significantly lower during operation than those before in group B（P〈0.05）.There was no any case with respiratory depression during operation and postoperative uterine contraction pain in group A.Transient intraoperative respiratory depression occurred in all cases in group B and two cases（3%）in group C.Postoperative uterine contraction pain took place in 45cases（75%）in group B.The time for the recovery of consciousness from anesthesia was longer in group C than that in groups of A and B[（15.21±0.97）min vs.（7.19±1.05）min and（7.11±1.04）min]（P〈0.05）.Conclusion It is a better choice to use propofol combined with ketorolac tromethamine for painless induced abortion.