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