Evaluation Of Subanesthestic Dose Ketamine Combine With Propofol In Painless Abortion

Objectives: To evaluate the efficacy and safety of different subanesthetic doses of ketamine combined with propofol in painless abortion in order to select the optimal subanesthetic doses of ketamine in the program.Methods: Two hundred and fifty ASAⅠEarly pregnant women, aged 18-35, with body mass index(BMI):20-25kg/m2, voluntarily scheduled for elective induced abortion, were randomly assigned into 5 groups(n=50) in accordance with different doses of ketamine: G1(0.1mg/kg+propofol), G2(0.2mg/kg+propofol), G3(0.3mg/kg+propofol), G4(0.4mg/kg+propofol), G5(0.5mg/kg+propofol). Ketamine was diluted with saline to 5ml and injected at the speed of 1ml/s,1 min later, propofol was injected at the rate of 1ml/2s. The surgery began until the subjects’ eyelash reflex disappeared, and the auditory evoked potentials index value(AAI)≤30. According to the specific conditions(AAI>30 or body movement occurred), additional propofol(0.5-1mg/kg) would be added to maintain the proper depth of anesthesia. Vital signs(heart rate,MAP,respiratory rate), Sp O2 and AAI were recorded respectively before the anesthesia(T0), 1min after the anesthesia(T1), at the time of the cervical dilation(T2), endouterine aspiration(T3), and the end of the surgery(T4). The untoward effect during the anesthesia such as dizziness, vomiting, body movement, respiratory depression, intravenous pain and intraoperative hypotension was observed. The time when the subjects became conscious and visual analogue scale(VAS) was noted down. The consumption of propofol was recorded as well.Results: 1.Vital signs:The change of blood pressure: ① comparison between different groups: G3, G4 and G5 were stabler(P<0.05); ②comparison on the basis of different time: the change rangeability at T1 and T0(%): G4<G5<G3<G2<G1; the change rangeability at T4 and T0(%): G4<G3<G5<G1<G2,namely, the change of G4 tended to be the smallest.The change of heart rate:① comparison between different groups: G3, G4 and G5 were stabler(P<0.05); ②comparison on the basis of different time: the change rangeability at T3 and T0(%): G4<G3<G5<G2<G1,namely, the change of G4 tended to be the smallest.The change of respiratory rate:① comparison between different groups: G2, G3, G4 and G5 were stabler;②comparison on the basis of different time: the change rangeability at T1 and T0(%): G5<G3<G4<G2<G1, that is, the change of G5 tended to be the smallest.The change of Sp O2:① comparison between different groups: G2, G3, G4 and G5 were stabler;②comparison on the basis of different time: the change rangeability at T1、T2、T3、T4 and T0(%):G5<G3<G4<G2<G1,that is, the change of G5 tended to be the smallest.2. Other indicesAn obvious diversity in dizziness rate: G4<G2<G3<G1<G5(P<0.05).No obvious diversity in vomiting rate: G4≈G3≈G1<G2<G5(P>0.05).An obvious diversity in body movement rate: G5<G4<G3<G2<G1(P<0.05).An obvious diversity in intravenous pain rate: G4≈G5<G3<G2<G1(P<0.05).An obvious diversity in intraoperative hypotension rate: G4≈G3<G5< G2<G1(P<0.05).An obvious diversity in the time of recovery of consciousness: G4<G5<G3<G1<G2(P<0.05).An obvious diversity in VAS:G4≈G5<G3<G1<G2(P<0.05).An obvious diversity in propofol dose: G5<G4<G3<G2<G1(P<0.05).Conclusion: The subjects in G4 with the application of subanesthestic dose ketamine combined with propofol in painless abortion maintained stable vital signs, recovered speedily and had low untoward effect rate for which we reckon the above mentioned approach worth recommending.