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丙泊酚/依托咪酯与丙泊酚/芬太尼用于无痛人流的疗效:一项随机临床试验。

Efficacy of Analgesic Propofol/Esketamine and Propofol/Fentanyl for Painless Induced Abortion: A Randomized Clinical Trial.

机构信息

Department of Anesthesiology, Maternal and Child Health Hospital of Hubei Province, China.

出版信息

Biomed Res Int. 2022 Jun 9;2022:5095282. doi: 10.1155/2022/5095282. eCollection 2022.

Abstract

BACKGROUND

Patients have widely accepted abortion as a remedy for contraceptive failure all over the world. Esketamine is a new anesthetic, sedative, and analgesic drug. Fentanyl is an opioid receptor agonist and a commonly used sedative. It is necessary to choose appropriate sedative drugs for painless abortion.

METHODS

We selected 238 cases of painless induced abortion from January 2020 to January 2022. We collected surgical parameters, the performance of sedation, and postoperative scales with complications before and after the operation. SPSS 21.0 was used to analyze data.

RESULTS

Surgical indicators between intervention and control groups had no difference; the preoperative indicators including intraoperative bispectral index (BIS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse oxygen saturation (SpO2) had no difference between the two groups. But after surgery, experiment groups had a higher value than the control group in these four indicators. The incidence of postoperative complications including nausea and vomit had no significant difference while the experiment group had a lower -value than the control group in hypotension, bradycardia, decreased oxygen saturation, and respiratory depression. The postoperative VAS score and Ramsay score in the experimental group were lower than those in the control group.

CONCLUSION

Since esketamine had better sedation performance, reduce the risk of cardiovascular and respiratory depression during sedation, and reduce the pain scale compared with fentanyl, we supported that propofol/esketamine is a good choice for patients receiving a painless induced abortion, and it is a sedation plan worth promoting and further analysis.

摘要

背景

在全球范围内,患者普遍接受将堕胎作为避孕失败的补救措施。氯胺酮是一种新型的麻醉剂、镇静剂和镇痛药。芬太尼是一种阿片受体激动剂,也是一种常用的镇静剂。因此,有必要为无痛人工流产选择合适的镇静药物。

方法

我们选择了 2020 年 1 月至 2022 年 1 月期间的 238 例无痛人工流产病例。收集手术参数、镇静效果和术后并发症评分。使用 SPSS 21.0 分析数据。

结果

干预组和对照组的手术指标没有差异;术前指标包括术中双频谱指数(BIS)、收缩压(SBP)、舒张压(DBP)和脉搏血氧饱和度(SpO2)在两组之间没有差异。但手术后,实验组的这四个指标的值均高于对照组。术后恶心呕吐并发症的发生率两组之间无显著差异,而实验组低血压、心动过缓、氧饱和度下降和呼吸抑制的发生率低于对照组。实验组术后 VAS 评分和 Ramsay 评分均低于对照组。

结论

与芬太尼相比,氯胺酮具有更好的镇静效果,降低了镇静期间心血管和呼吸抑制的风险,并降低了疼痛评分,因此我们支持丙泊酚/氯胺酮是接受无痛人工流产患者的良好选择,是一种值得推广和进一步分析的镇静方案。

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