目的:评价丙泊酚复合芬太尼、单纯丙泊酚或氯胺酮用于无痛人流术的效果。方法:选择120例ASAⅠ~Ⅱ级早期妊娠、要求做人工流产术的孕妇,随机分为4组(每组30例)。A组:不用任何麻醉药。B组:单纯丙泊酚2~4 mg/kg;C组:丙泊酚1~2mg/kg复合少量芬太尼1μg/kg;D组:单独用氯胺酮0.5~1mg/kg。结果:A组对循环系统影响最大;B组对循环系统和呼吸系统有一定影响,而丙泊酚用量最大(2~4 mg/kg);C组丙泊酚用量少(1~2 mg/kg),对循环系统和呼吸系统影响小,术后宫缩痛发生率低于A、B两组;D组苏醒时间平均延长50min。结论:单独使用氯胺酮同样能达到完善的镇静、镇痛效果,但术中恶梦多,苏醒时间延长,影响病人离院时间;丙泊酚配合少量芬太尼即可减少丙泊酚的总用量,又能有效抑制或减轻宫缩痛,对循环系统和呼吸系统影响较小,从而提高患者的满意度〔2,3〕。 PURPOSE: To evaluate the efficacy of propofol combined with fentanyl, propofol or ketamine for painless abortion. Methods: 120 pregnant women with ASA grade Ⅰ ~ Ⅱ early pregnancy were enrolled. Pregnant women who requested abortion were randomly divided into 4 groups (30 in each group). Group A: without any anesthetic. Group B: simple propofol 2-4 mg / kg; Group C: propofol 1-2 mg / kg combined with fentanyl 1 μg / kg; Group D: ketamine 0.5-1 mg / kg alone. Results: Group A had the most significant effect on the circulatory system; group B had some effects on the circulatory system and respiratory system, while propofol was the highest (2-4 mg / kg); while group C used less propofol (1-2 mg / kg), the impact on the circulatory system and respiratory system is small, the incidence of postoperative contractions pain is lower than A, B; D group recovery time average 50min. Conclusions: Ketamine alone can also improve the sedative and analgesic effects, but more intraoperative nightmares and longer awakening times affect the patient’s time away from hospital; propofol combined with a small amount of fentanyl can reduce the total dosage of propofol , But also effectively inhibit or reduce uterine pain, the circulatory system and respiratory system less affected, thereby enhancing patient satisfaction [2,3].