丙泊酚复合艾司氯胺酮或芬太尼在无痛人工流产术中的应用

摘要/Abstract

摘要： 目的比较丙泊酚复合艾司氯胺酮或芬太尼应用于无痛人工流产术的效果。方法选取2021年2月—2021年5月在清远市人民医院静脉全麻下行人工流产术的患者60例,采用随机数表法将患者分为A、B两组。A组：丙泊酚复合艾司氯胺酮组（30例）,B组：丙泊酚复合芬太尼组（30例）。A组患者静脉注射艾司氯胺酮0.2 mg/kg、丙泊酚1.5 mg/kg,B组静脉注射芬太尼1 μg/kg、丙泊酚1.5 mg/kg。分别记录两组患者术中丙泊酚用量,需要追加丙泊酚的例数,苏醒时间,采用疼痛数字评分法（NRS）评价两组患者苏醒后5 min、15 min、30 min静息和活动时子宫收缩痛的程度。记录与镇静相关的不良事件（低氧血症、心动过缓、恶心呕吐等）发生情况。结果与B组相比,A组患者丙泊酚用量、丙泊酚追加例数、苏醒时间明显减少（P<0.05）。A组苏醒后5 min、15 min、30 min 活动时NRS评分明显降低（P<0.05）。A组低氧血症、心动过缓、需要开放气道干预发生率明显低于B组（P<0.05）。结论丙泊酚复合艾司氯胺酮可以减少无痛人工流产术中丙泊酚用量,提高术后镇痛效果,不良反应较少,值得在妇科门诊手术中应用。

关键词: 丙泊酚, 艾司氯胺酮, 芬太尼, 无痛, 人工流产术

Abstract: Objective To compare the effect of esketamine or fentanyl combined with propofol in painless induced abortion。MethodsFrom February 2021 to May 2021, 60 patients who underwent induced abortion under intravenous general anesthesia in the gynecological Operating room of the day Clinic of Qingyuan People's Hospital were randomized into group A (esketamine combined with propofol) or group B (fentanyl combined with propofol), with 30 patients in each group.In group A, patients received intravenous esketamine 0.2 mg/kg, propofol 1.5 mg/kg. In group B, sedation was provided by intravenous fentanyl 1 μg/kg and propofol 1.5 mg/kg. The recovery times, total propofol consumption and number of patients intravenous propofol additional were recorded, and the degree of uterine contractions pain during rest and activity at 5 min, 15 min, 30 min were assessed by numeric rating scale (NRS). The adverse events related to sedation (hypoxemia, bradycardia, nausea and vomiting, et al) were recorded. Results Compared with group B,recovery times in group A was significantly shorter, the total propofol dosage and the number of people need additional propofol were significantly decreased (P<0.05). The degree of uterine contractions pain during activity at 5 min, 15 min, 30 min were significantly lower than that in group B (P<0.05). The incidence of hypoxemia, bradycardia, and the need for open airway intervention were significantly lower than that in group B (P<0.05). ConclusionPropofol combined with esketamine can reduce propofol dosage requirements in painless induced abortion, improve the postoperative analgesic effect, and have few adverse effects, which is worth clinical application.

Key words: propofol, esketamine, fentanyl, painless, abortion

中图分类号:

R614.2

周洁芳, 黄义洲, 向文跃, 梁秀生. 丙泊酚复合艾司氯胺酮或芬太尼在无痛人工流产术中的应用[J]. 中华养生保健, 2023, 41(6): 36-39.

ZHOU Jie-fang, HUANG Yi-zhou, XIANG Wen-yue, LIANG Xiu-sheng. Application of Propofol Combined with Esketamine or Fentanyl in Painless Artificial Abortion[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(6): 36-39.

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