2種異丙酚鎮靜方案在婦科腹腔鏡檢查術中的比較_《華西醫學》

作者：

四川大學華西第二醫院麻醉科,四川成都 610041;

關鍵詞：

異丙酚氯胺酮芬太尼腹腔鏡檢查術

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目的:采用隨機雙盲方法比較異丙酚分別聯合芬太尼和氯胺酮在門診婦科腹腔鏡檢查術中的應用。方法:行門診婦科腹腔鏡檢查術的女性患者60例,隨機分為芬太尼-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,靜脈緩推異丙酚2.5mg/kg行鎮靜誘導。采用雙盲法觀察鎮靜誘導時間和異丙酚注射痛、術中異丙酚追加量和呼吸循環改變、術后惡心嘔吐(PONV)、患者清醒出院時間、及患者的滿意度。結果:K組的鎮靜誘導時間短于F組,其異丙酚注射痛的發生率和嚴重程度明顯低于F組。F組術中需要追加異丙酚的人數、異丙酚平均追加量、以及需阿托品和輔助通氣治療的人數均明顯高于K組。K組的清醒時間長于F組。兩組的出院時間、PONV和患者麻醉滿意度差異無統計學意義。結論:較1 μg/kg芬太尼相比,1mg/kg氯胺酮聯合異丙酚是門診婦科腹腔鏡檢查術更安全有效的鎮靜方案。

引用本文： 唐昱英,林雪梅,黃蔚. 2種異丙酚鎮靜方案在婦科腹腔鏡檢查術中的比較. 華西醫學, 2009, 24(9): 2428-2430. doi: 復制

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.
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.	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.

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.
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. 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.

《華西醫學》

2種異丙酚鎮靜方案在婦科腹腔鏡檢查術中的比較

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《華西醫學》

2種異丙酚鎮靜方案在婦科腹腔鏡檢查術中的比較

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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