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目的:观察舒芬太尼、芬太尼及氯胺酮用于门诊人工流产术的麻醉效果。方法:选择150例门诊自愿终止妊娠的早孕患者ASAⅠ～Ⅱ级。随机分为3组(每组50例)舒芬太尼组(S组),芬太尼组(F组)、氯胺酮组(K组)。各组联合丙泊酚首次剂量为2.5mg·kg~(-1),观察无痛人工流产的疗效及不良反应。结果:HR:K组变化显著(P<0.01)。MAP:F组下降有统计学差异(P<0.01)。SPO_2:三组均无统计学差异。丙泊酚用量:K组量较大有统计学差异(P<0.01)。术中患者扭动次数: S组低于F组(P<0.05),明显低于K组(P<0.01)。离院时间:K组离院时间最长(P<0.01)。术后宫缩痛评分:S组优于F组(P<0.05),明显优于K组(P<0.01)。结论:舒芬太尼(0.1μg·kg~(-1))联合丙泊酚用于门诊人工流产术麻醉的镇痛效果最佳。
Objective: To observe the anesthetic effects of sufentanil, fentanyl and ketamine in outpatient induced abortion. Methods: 150 ASA Ⅰ ~ Ⅱ patients with early pregnancy who voluntarily terminated pregnancy were selected. The patients were randomly divided into three groups (50 in each group), sufentanil group (S group), fentanyl group (F group) and ketamine group (K group). The first dose of combination propofol was 2.5 mg · kg ~ (-1) in each group, and the curative effect and adverse reaction of painless induced abortion were observed. Results: HR: K group changed significantly (P <0.01). MAP: F group decreased statistically significant (P <0.01). SPO_2: no significant difference between the three groups. Propofol dosage: K group was statistically significant (P <0.01). The number of patients writhing in operation was significantly lower in group S than in group F (P <0.05), significantly lower than that in group K (P <0.01). Losing time: K group was the longest departure time (P <0.01). Postoperative uterine pain score: S group was better than F group (P <0.05), which was significantly better than K group (P <0.01). Conclusion: Sufentanil (0.1μg · kg ~ (-1)) combined with propofol has the best analgesic effect in outpatient induced abortion anesthesia.