艾司氯胺酮复合不同剂量丙泊酚在无痛人流术中的应用分析
DOI:
作者:
作者单位:

1.南京医科大学附属脑科医院;2.南京医科大学第一临床医学院;3.南京医科大学第一附属医院麻醉与围术期医学科

作者简介:

通讯作者:

中图分类号:

基金项目:

国家自然科学基金项目(面上项目,重点项目,重大项目)


Application and analysis of esmketamine combined with different doses of propofol in painless induced abortion
Author:
Affiliation:

1.The First Clinical College of Medicine,Nanjing Medical University;2.China;3.Department of Anesthesia and Perioperative Medicine,The First Affiliated Hospital of Nanjing Medical University

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:探讨在艾司氯胺酮复合不同剂量丙泊酚用于无痛人流术的有效剂量和安全性。方法:共计88例拟行无痛人工流产术的18~40周岁年轻女性患者, 按序贯法要求随机纳入1.5mg/kg、2.0mg/kg、2.5mg/kg丙泊酚组中,三组患者依次给予不同剂量艾司氯胺酮,统计并测算50%患者对手术刺激体动反应时所需的艾司氯胺酮(ED50),麻醉中连续监测患者心率(HR)、平均动脉压(MAP)和脉搏氧饱和度(SpO2),以及麻醉、苏醒时间和围术期不良反应等资料。结果:①三组艾司氯胺酮的ED50依次减少,分别为0.320(0.281-0.364)、0.244(0.207-0.291) 、0.167(0.078-0.320),差异具有统计学意义(p<0.01)②丙泊酚3组T1的HR较T0明显下降 (p<0.05),其余两组则无明显差异;丙泊酚2组和3组T1的MAP较T0明显下降(p<0.05),丙泊酚3组诱导后MAP显著低于1组(p<0.05);③各组有效病例恢复室滞留时间组间存在明显差异(p<0.05),④丙泊酚3组低血压、呼吸抑制发生率明显高于其余两组(p<0.05),丙泊酚1组术中呛咳、苏醒后头痛的发生率显著高于其余两组(p<0.05)结论:在中青年女性患者无痛人工流产术中, 2.0mg/kg丙泊酚联合艾司氯胺酮的麻醉方案综合效果最佳,其中艾司氯胺酮的ED50、ED95分别为 0.214(0.195-0.236)mg/kg、0.334(0.282-0.557)mg/kg。

    Abstract:

    Objective: To investigate the effective dosage and safety of esketamine combined with different doses of propofol for painless abortion. Methods: A total of 88 young female patients aged 18 to 40 years who were scheduled for painless induced abortion were randomly assigned to receive 1.5 mg/kg, 2.0 mg/kg, or 2.5 mg/kg propofol according to the sequential method,and were sequentially given different doses of esketamine.Esketamine required by 50% of patients to respond to the motor stimulation of surgery was calculated. The patients' heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) were continuously monitored during anesthesia, and data on anesthesia and recovery time, as well as perioperative adverse reactions, were recorded. Results: ①The ED50 of esketamine in the three groups decreased successively(p<0.01), which were 0.320(0.281-0.364), 0.244(0.207-0.291) and 0.167(0.078-0.320), respectively.② The HR of T1 in 2.5mg/kg propofol group was significantly decreased compared with T0 (p<0.05), but there was no significant difference between the other two groups. The MAP of T1 in 2mg/kg and 2.5mg/kg propofol groups was significantly lower than that in T0 group (p<0.05), and the MAP in 2.5mg/kg propofol group was significantly lower than that in 1.5mg/kg group (p< 0.0167);③ There were significant differences in recovery room retention time among all groups (p<0.05);④ There were significant differences in the incidence of hypotension and respiratory depression in 2.5mg/kg propofol group (p<0.05). The incidence of choking and headache after recovery in 1.5mg/kg propofol group was significantly higher than that in the other two groups (p < 0.05). Conclusion: In young female patients undergoing painless induced abortion, the anesthesia scheme of 2.0 mg/kg propofol combined with ketamine had the best overall effect, with the ED50 and ED95 of ketamine being 0.214 (0.195-0.236) mg/kg and 0.334 (0.282-0.557) mg/kg, respectively.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2023-01-17
  • 最后修改日期:2023-04-24
  • 录用日期:2023-10-20
  • 在线发布日期:
  • 出版日期: