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目的比较丙泊酚联合氯胺酮、芬太尼、曲马多的麻醉效果,探讨无痛人流麻醉药物的最佳配伍。方法120例需要无痛人流的病人随机分三组,丙泊酚配伍。A组:氯胺酮10mg,B:组芬太尼0.5kg-1,C组:曲马多1mg.kg-1。结果三组镇静镇痛效果相似;芬太尼组循环呼吸抑制较氯胺酮、曲马多组明显(p>0.01或0.05);氯胺酮组丙泊酚注射痛较少(p>0.01),定向力恢复时间延长(p>0.01),结论三组药物均可用于门诊无痛人流的麻醉,联合芬太尼时注意病人循环和呼吸的抑制,应用氯胺酮时局部注射痛较少发生但会延长病人定向力的恢复。临床使用时根据具体情况选择不同的药物配伍。
Objective To compare the anesthetic effects of propofol combined with ketamine, fentanyl and tramadol to explore the best compatibility of painless anesthetic. Methods One hundred and twenty patients with painless abortion were randomized into three groups with propofol compatibility. Group A: ketamine 10mg, B: fentanyl 0.5kg-1, C: tramadol 1mg.kg-1. Results The antitussive analgesic effect of the three groups was similar; the respiration of fentanyl group was significantly lower than that of ketamine and tramadol group (p> 0.01 or 0.05); the ketamine group had less propofol injection pain (p> 0.01) (P> 0.01). Conclusion All the three groups of drugs can be used for painless outpatient anesthesia. When combined with fentanyl, patients should pay attention to the inhibition of patient’s circulation and respiration. Local injection pain is less likely to occur when ketamine is used, but it will prolong patient’s directional force Recovery. When clinical use according to the specific circumstances choose different drug compatibility.