【摘要】 目的 观察异丙酚―氯胺酮静脉复合麻醉用于门诊隆乳手术的临床效果。方法 126例ASAⅠ～Ⅱ级门诊隆乳手术患者，静脉注射咪唑安定2mg，然后靶控输注异丙酚,维持血浆浓度3μg/ml，在术者分离两侧胸大肌深面前5min，加氯胺酮1～1.5mg/kg，手术缝合时停止泵注异丙酚。观察基础值、麻醉后、手术开始时、分离胸大肌时、术毕时的血流动力学变化及术毕清醒时间、恶心、呕吐发生率。结果 组内血流动力学：心率(HR)、收缩压(SBP)、舒张压(DBP)稳定，与术前相比差异无显著性(P>0.05)；22例(17%)苏醒期间有轻微头晕，10例(8%)恶心，无呕吐。 结论 异丙酚―氯胺酮静脉复合应用能产生药物协同作用，且对呼吸循环功能干扰小，可保持隆乳手术过程平稳安全。

    【关键词】 异丙酚；氯胺酮；静脉复合麻醉；隆乳术

    Effect of propofol-ketamine total intravenous anesthesia in the mammaplasty

    JIA Lian-ming，YU Wen-fu.Department of Anesthesiology,Shanghai Electrical Power Hospital,Shanghai 200050,China

    【Abstract】 Objective To observe the effect of propofol-ketamine total intravenous anesthesia(TIVA) in the mammaplasty. Methods 126 ASAⅠ～Ⅱ patients received breast swelling operation.2mg midazolam was intravenous injected, anesthesia was maintained with TCI of propofol of which the plasma concentration was set at 3μg/ml.During the seperation of musculus pectoralis major,ketamine was given 1～1.5mg/kg intravenous injection. Stop the injection of propofol at the time of suture.Record the hemodynamic parameters(HR,SBP,DBP) before anesthesia,after anesthesia,the beginning of operation,the time of musculus pectoralis major and the end of operation.and at the time of consciousness,the incidences of nausea and vomitting were observed. Results The differences of the hemodynamic parameters(HR,SBP,DBP) were insignificant(P>0.05) at the various recording time.22 patients(18%) had slight dizziness .10 patients(8% )had slight nausea at the time of consciousness. Conclusion Propofol-ketamine TIVA may be increase effective,the side effect and the influence on the respiratory and circulative function are little,and maintain the stability and safety in the mammaplasty. ......