• 四川大學(xué)華西第二醫(yī)院麻醉科,四川成都 610041;

目的:采用隨機(jī)雙盲方法比較異丙酚分別聯(lián)合芬太尼和氯胺酮在門診婦科腹腔鏡檢查術(shù)中的應(yīng)用。方法:行門診婦科腹腔鏡檢查術(shù)的女性患者60例,隨機(jī)分為芬太尼-異丙酚組(F組)和氯胺酮-異丙酚組(K組),每組30例。F組和K組分別靜注芬太尼1 μg/kg和氯胺酮1mg/kg后,靜脈緩?fù)飘惐?.5mg/kg行鎮(zhèn)靜誘導(dǎo)。采用雙盲法觀察鎮(zhèn)靜誘導(dǎo)時(shí)間和異丙酚注射痛、術(shù)中異丙酚追加量和呼吸循環(huán)改變、術(shù)后惡心嘔吐(PONV)、患者清醒出院時(shí)間、及患者的滿意度。結(jié)果:K組的鎮(zhèn)靜誘導(dǎo)時(shí)間短于F組,其異丙酚注射痛的發(fā)生率和嚴(yán)重程度明顯低于F組。F組術(shù)中需要追加異丙酚的人數(shù)、異丙酚平均追加量、以及需阿托品和輔助通氣治療的人數(shù)均明顯高于K組。K組的清醒時(shí)間長(zhǎng)于F組。兩組的出院時(shí)間、PONV和患者麻醉滿意度差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:較1 μg/kg芬太尼相比,1mg/kg氯胺酮聯(lián)合異丙酚是門診婦科腹腔鏡檢查術(shù)更安全有效的鎮(zhèn)靜方案。

引用本文： 唐昱英,林雪梅,黃蔚. 2種異丙酚鎮(zhèn)靜方案在婦科腹腔鏡檢查術(shù)中的比較. 華西醫(yī)學(xué), 2009, 24(9): 2428-2430. doi: 復(fù)制

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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.
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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.
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  2. 2. MCCRIRRICK A, HUNTER S. Pain on injection of propofol: the effect of injectate temperature[J]. Anaesthesia,1990,45:443-444.
  3. 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. 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.
  5. 5. SA REGO M M, WATCHA M F, WHITE P F. The changing role of monitored anesthesia care in the ambulatory setting[J]. Anesth Analg,1997,85:1020-1036.
  6. 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. 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. 8. TAN C H, ONSIONG M K. Pain on injection of propofol[J]. Anaesthesia,1998,53:468-476.
  9. 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.