【摘要】 目的观察异丙酚复合氯胺酮在无痛人流术中对听觉诱发电位指数(auditory evoked potentials index,AAI)的影响。方法选择门诊无痛人流患者56例,随机分成异丙酚(Ⅰ组,n=28)和异丙酚复合氯胺酮(Ⅱ组,n=28)。记录给药前、后,整个手术过程及术毕苏醒过程中各时点的AAI值、OAA/S评分、平均动脉压(MAP)、心率(HR)及血氧饱和度(SpO2)以及异丙酚用量、苏醒时间及质量。结果两组AAI值和OAA/S评分在给药后及整个手术期间均明显降低,与自身给药前相比,有非常显著差异(P<0.01);Ⅱ组AAI下降的时间及恢复时间滞后于Ⅰ组,AAI值与OAA/S评分有良好的相关性。两组在给药后MAP均有下降,与给药前相比,有显著性差异(P<0.05);而HR和SpO2无明显变化。Ⅱ组与Ⅰ组相比,Ⅱ组异丙酚用量明显少于Ⅰ组,苏醒时间长于Ⅰ组;苏醒质量无显著性差异。结论AAI能较好的反映异丙酚的镇静水平,同时也可反映异丙酚复合氯胺酮后的总体镇静程度,但反映速度滞后,需结合临床进行整体判断。氯胺酮对AAI的影响不大,氯胺酮不干扰异丙酚引起的AAI值的变化。更多还原

【Abstract】 Objective Observed the effcets of propofol combined with ketamine to AAI in painless induced abortion.Methods Choose 56 women would be carry out operation of painless induced abortion,divided with two groups randomly,group Ⅰ was injected 2～2.5mg/kg propofol,group Ⅱ was injected 0.5mg/kg ketamine and propofol.Recording the changes of AAI,OAA/S,MAP,HR,SpO₂,total dose of propofol,time of awakness before administration,after admministration,whole operation procdure and every time point of awaking.Results AAI and OAA/S decrease markly after administration and whole operation procedure two groups,and the time of AAI decreasing and recovery group Ⅰ quicker than that group Ⅱ.After operation,AAI and OAA/S increase gradually to level before administration at 7min group Ⅰand 10min group Ⅱ after operation.It have well correlation AAI and OOA/S.MAP decrease markly two groups after administration,and no significantly change of HR and SpO₂.Compared with group Ⅰ,dose of propofol group Ⅱ less than of group Ⅰ obviously,time of awaking longer than group Ⅰ significantly.Conclusion AAI can well reflect sedation level of propofol,and can reflect populational sedation degree of ketamine combined with propofol simultaneously,the reflection of AAI hysteresis,so depth of anesthesia judgement would integrate clincal situation.Ketamine influenced AAI very few and ketamine uninterference with changes of AAI induced propofol.更多还原