2种异丙酚镇静方案在妇科腹腔镜检查术中的比较_West China Medical Journal

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异丙酚; 氯胺酮; 芬太尼; 腹腔镜检查术

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目的:采用随机双盲方法比较异丙酚分别联合芬太尼和氯胺酮在门诊妇科腹腔镜检查术中的应用。方法:行门诊妇科腹腔镜检查术的女性患者60例,随机分为芬太尼-异丙酚组(F组)和氯胺酮-异丙酚组(K组),每组30例。F组和K组分别静注芬太尼1 μg/kg和氯胺酮1mg/kg后,静脉缓推异丙酚2.5mg/kg行镇静诱导。采用双盲法观察镇静诱导时间和异丙酚注射痛、术中异丙酚追加量和呼吸循环改变、术后恶心呕吐(PONV)、患者清醒出院时间、及患者的满意度。结果:K组的镇静诱导时间短于F组,其异丙酚注射痛的发生率和严重程度明显低于F组。F组术中需要追加异丙酚的人数、异丙酚平均追加量、以及需阿托品和辅助通气治疗的人数均明显高于K组。K组的清醒时间长于F组。两组的出院时间、PONV和患者麻醉满意度差异无统计学意义。结论:较1 μg/kg芬太尼相比,1mg/kg氯胺酮联合异丙酚是门诊妇科腹腔镜检查术更安全有效的镇静方案。

Citation： 唐昱英,林雪梅,黄蔚. 2种异丙酚镇静方案在妇科腹腔镜检查术中的比较. West China Medical Journal, 2009, 24(9): 2428-2430. doi: Copy

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1. BRYSON H M, FULTON B R, FAULDS D. Propofol: An update of its use in anaesthesia and conscious sedation[J]. Drugs,1995,50:513-559.
2. MCCRIRRICK A, HUNTER S. Pain on injection of propofol: the effect of injectate temperature[J]. Anaesthesia,1990,45:443-444.
3. HENDRICKX J F, EGER EI 2ND, SONNER J M, et al. Is synergy the rule A review of anesthetic interactions producing hypnosis and immobility[J]. Anesth Analg,2008,107:494-500.
4. HUI T W, SHORT T G, HONG W, et al. Additive interactions between propofol and ketamine when used for anesthesia induction in female patients[J]. Anesthesiology,1995,82:641648.
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6. LERMAN J. Surgical and patient factors involved in postoperative nausea and vomiting[J]. Br J Anaesth,1992,69(7 Suppl 1):24-32.
7. SUBRAMANIA KATHIRVEL, SUBRAMANIAM BALACHUNDHAR, STEINBROOK RICHARD A. Ketamine as adjuvant analgesic to opioids: A Quantitative and Qualitative Systematic Review[J]. Anesth Analg,2004,99:482-495.
8. TAN C H, ONSIONG M K. Pain on injection of propofol[J]. Anaesthesia,1998,53:468-476.
9. KOO S W, CHO S J, KIM Y K, et al. Smalldose ketamine reduces the pain of propofol injection[J]. Anesth Analg,2006,103:444-447.

West China Medical Journal

2种异丙酚镇静方案在妇科腹腔镜检查术中的比较

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