丙泊酚联合氯胺酮在无痛人流中的临床观察

目的探讨丙泊酚联合氯胺酮在无痛人流中的临床效果。方法选择自愿终止妊娠、美国麻醉医师协会（ASA）分级Ⅰ-Ⅱ级的早孕妇女120例，随机分为观察组和对照组，每组各60例。观察组给予丙泊酚（100mg）联合氯胺酮（10mg）；对照组给予丙泊酚（130mg）。记录麻醉诱导前、诱导后两组患者的血压、心率、呼吸频率、脉搏血氧饱和度，并记录注射部位疼痛、术中体动、术后腹痛及苏醒评分（steward评分）的情况。结果两组患者麻醉效果均满意，麻醉前后血压、心率、呼吸频率、脉搏氧饱和度差异均无统计学意义（P〉0．05）；观察组追加丙泊酚次数明显少于对照组，差异有统计学意义（P=0．000）；观察组苏醒评分高于对照组[（3．88±0．32VS．3．30±0．46）]，差异有统计学意义（P=0．000）；观察组注射部位疼痛、术中体动、术后腹痛比例均低于对照组（5．00％VS．25．00％，8．33％VS．38．33％，8．33％vs．41．67％），差异有统计学意义（P=0．000）。结论丙泊酚联合氯胺酮在无痛人流中麻醉效果确切，苏醒快，不良反应少。

Objective To explore the clinical efficacy of propofol combined with ketamine in painless induced abortion.Methods One hundred and twenty pregnancy womens with voluntary abortion were randomly divided into observation group and control group, and each group of 60 cases. Observation group was administered with propofol 100mg and ketamine 10 m, and control group was administered with propofol 130mg. Blood pressure, heart rate, respiration rate and saturation of pulse oximetry were recorded before anesthesia induction and after anesthesia induction, meanwhile injection pain, body movement, abdominal pain of after surgery and steward scores were noted also. Results Blood pressure, heart rate, respiration rate and saturation of pulse oximetry of two group were no statistical difference （ P〉0.05 ） ; Administration times of observation group significantly less than control group, and it was of statistical difference （ P=0.000 ） . Observation group Steward scores was higher than control group （ 3.88 ±0.32 vs. 3.30± 0.46 ） , and it was of statistical difference （ P=0.000 ） ; Injection pain, body movement, and abdominal pain of after surgery were lower than control group （ 5.00% vs. 25.00%, 8.33% vs. 38.33%, 8.33%vs. 41.67% ） , and it is statistical difference （ P=0.000 ） . Conclusion Propofol combined with ketamine has sound anesthesia efficacy, rapidly recovery and less adverse effect in painless induced abortion.