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目的 探讨阈下剂量氯胺酮复合丙泊酚用于人工流产术的麻醉效果及其对呼吸、循环功能的影响 .方法180例ASAⅠ～Ⅱ级择期人工流产病人 ,随机分成两组各 90例 ,Ⅰ组丙泊酚 3mg/kg,Ⅱ组氯胺酮 0 .4mg/kg加丙泊酚2mg/kg ,术中视病人反应及手术时间追加丙泊酚 30mg～ 5 0mg,记录注药前、注药后 2min、5min的血压、心率、呼吸变化和丙泊酚用量 .结果 注药后 2minSBP、DBP、HR达到最大降幅 ,分别下降 :Ⅰ组 2 2 %、2 3%、2 6 % ,Ⅱ组 12 %、15 %、19% ,两组同期值比较有显著性差异 (p <0 .0 1) .Ⅱ组丙泊酚用量接近Ⅰ组的半量 (p <0 .0 1) .结果表明阈下剂量氯胺酮具有明显镇痛作用 ,和丙泊酚的催眠作用明显协同 ,能降低丙泊酚的诱导剂量和减轻丙泊酚对循环抑制作用 .结论 阈下剂量氯胺酮复合丙泊酚是人工流产术的一种理想麻醉用药方法
Objective To investigate the effect of subthreshold dose ketamine combined with propofol on induced abortion and its effects on respiration and circulatory function.Methods 180 patients with ASA Ⅰ ~ Ⅱ elective abortion were randomly divided into two groups (n = 90), group Ⅰ Propofol 3mg / kg, Ⅱ ketamine 0.4mg / kg plus propofol 2mg / kg intraoperative depending on the patient response and surgery time propofol 30mg ~ 50mg, before recording injection, injection 2min, 5min Blood pressure, heart rate, respiration and dosage of propofol were measured.Results Serum BP, DBP and HR reached the maximum decrease at 2min after injection, respectively, which were decreased in group I (22%, 23%, 26% , 19%, there was significant difference between the two groups in the same period (p <0.01) .The dosage of propofol in group Ⅱ was close to that in group Ⅰ (p <0.01) .The results showed that subliminal dose of ketamine had obvious Analgesic effect and synergetic hypnotic effect of propofol significantly reduce the induction dose of propofol and reduce the inhibitory effect of propofol on the circulation.Conclusion Subthreshold dose of ketamine combined with propofol is an ideal anesthesia for induced abortion Medication method