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目的 :对丙泊酚与 3种麻醉性镇痛药复合应用于人工流产进行临床观察。方法 :40例早期妊娠行人工流产手术患者 ,随机分成丙泊酚组 (P组 )、丙泊酚加芬太尼组 (F组 )、丙泊酚加氯胺酮组 (K组 )和丙泊酚加哌替啶组 (D组 ) ;每组 10例。P组静注丙泊酚 2 .5mg/kg ,F ,K ,D组静注丙泊酚 1.5mg/kg分别加芬太尼 2 μg/kg ,氯胺酮 1mg/kg ,哌替啶 2mg/kg麻醉诱导 ;待意识消失后 ,均以丙泊酚 0 .3mg/ (kg·min)维持麻醉。结果 :F ,K组起效时间明显快于P组 (P <0 .0 1) ,而D组变化不明显 ;苏醒时间除K组较P组延长外 ,其余均无明显变化 ;呼吸循环的变化各组间无显著差异。F ,K组术中无 1例发生肢体活动 ,而P ,D组发生率分别为 10 0 %和 6 0 %。结论 :芬太尼、氯胺酮对丙泊酚的药效学有加强作用 ,而哌替啶此作用不明显 ;丙泊酚复合小剂量芬太尼静脉麻醉用于门诊无痛人工流产手术是一种较为合理、安全可行的麻醉方法。
OBJECTIVE: To observe the clinical effect of propofol combined with three kinds of narcotic analgesics on artificial abortion. Methods: Forty patients with abortion during early pregnancy were randomly divided into two groups: propofol group (group P), propofol plus fentanyl group (group F), propofol plus ketamine group (group K) and propofol Plus Pethidine group (D group); 10 cases in each group. Group P were intravenously administered with propofol 2.5mg / kg, group F, K, D intravenously with propofol 1.5mg / kg respectively plus fentanyl 2μg / kg, ketamine 1mg / kg and pethidine 2mg / kg Induced; to be aware of disappeared, were propofol 0.3 mg / (kg · min) to maintain anesthesia. Results: The onset time of group F and K was significantly faster than that of group P (P <0.01), while the change of group D was insignificant. The recovery time of group K was longer than that of group P No significant difference between the groups was observed. No physical activity occurred in 1 patient in group F and group K, but the incidences in groups P and D were 100% and 60% respectively. Conclusion: Fentanyl, ketamine to enhance the pharmacodynamics of propofol, and the role of pethidine is not obvious; propofol combined with small doses of intravenous fentanyl anesthesia for out-patient painless abortion is a More reasonable, safe and feasible method of anesthesia.