氯胺酮复合异丙酚麻醉在小儿疝高位结扎术中的应用(1)
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[摘要] 目的 观察氯胺酮复合异丙酚麻醉在小儿疝高位结扎术中的应用。 方法 拟行疝高位结扎术患儿60例，按随机数字表分成3组，Ⅰ组患者麻醉诱导予氯胺酮2 mg/kg缓慢静脉注射，术中间断静注氯胺酮1 mg/kg维持麻醉；Ⅱ组患儿先予氯胺酮和异丙酚各2 mg/kg诱导，麻醉维持予异丙酚8 mg/(kg·h)连续泵注；Ⅲ组患者麻醉诱导用芬太尼1 μg/kg，异丙酚2 mg/kg，麻醉维持以异丙酚8 mg/(kg·h)连续泵注。观察3组患者在麻醉前(T0)，诱导后(T1)，手术时(T2)以及术毕(T3)时的HR、MAP、SpO2以及苏醒时间和不良反应发生情况。 结果 Ⅰ组患者HR、MAP在T1、T2、T3时间点均较T0明显上升(P < 0.05)，Ⅲ组HR、MAP、SpO2在T1时间点较T0明显下降(P < 0.05)，Ⅱ组各参数于T1、T2、T3与T0比较均差异无统计学意义。Ⅲ组呼吸抑制和呛咳明显(P < 0.05)，Ⅰ组惊厥明显(P < 0.05)。 结论 氯胺酮复合异丙酚静脉麻醉能提供较完善的镇静镇痛，可安全有效地应用于小儿疝手术。
[关键词] 氯胺酮；异丙酚；芬太尼；麻醉；小儿；疝高位结扎术
[中图分类号] R971+.2 [文献标识码] A [文章编号] 1674-4721(2012)03(a)-0082-02
Clinical observation of combine Ketamine and Propofol in pediatric inguinal hernia high ligation
ZHANG Huifang WANG Yaping
1.Department of Anesthesiology, the Third Hospital in Changsha City of Hunan Province, Changsha 410000, China; 2.Department of Anesthesiology, Xiangya Second Hospital of Central South University in Hunan Province, Changsha 410000, China
[Abstract] Objective To evaluate the effect of combine Ketamine and Propofol in pediatric inguinal hernia high ligation. Methords Sixty children scheduled for pediatric inguinal hernia high ligation were divided into three groups: groupⅠ was injected intravenously with Ketamine 2 mg/kg for inducing, and anesthesia was maintained with Ketamine 1 mg/kg interruptedly; groupⅡ was inducted with Ketamine 2 mg/kg and Propofol 2 mg/kg, anesthesia was maintained with Propofol 8 mg/(kg·h) infusion; group Ⅲ was inducted with fentanyl 1 μg/kg and Propofol 2 mg/kg, maintained with Propofol 8mg/(kg·h) infusion. Mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) were recorded before anesthesia (T0), after induction (T1), during operation (T2), after operation (T3), the average awakening time after operation and side-effects were observed. Results HR, MAP in group Ⅰ ascend significantly at T1, T2, T3 compared with T0; HR, MAP, SpO2 in group Ⅲ decreased significantly at T1 compared with T0; HR, MAP, SpO2 in group Ⅱ did not show obvious differences between T0-T3, the awakening time in groupⅡand group Ⅲ was shorter than group Ⅰ obviously, the rate of respiratory inhibition was higher in group Ⅲcompared with group Ⅰ and group Ⅱ, convulsion in groupⅠwas obviously ......
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