摘要
目的 观察丙泊酚复合小剂量氯胺酮用于小儿眼科手术对血流动力学的影响和术后恢复情况。方法 选择60例ASAI～Ⅱ级行择期小儿眼科手术患者,随机分为丙泊酚复合小剂量氯胺酮组(PK组)和氯胺酮组(K组),每组30例。观察各时间点的心率(HR)、平均动脉压(MAP)及眼内压(IOP)。停药后记录完全清醒时间和评估术后恶心、呕吐的情况。结果 K组气管插管时、手术开始时、术中第15 min及手术结束时的HR、MAP与麻醉前相比均有增快和升高(P<0.05或P<0.01)。两组的相应各时点参数相比较均有极显著性差异(P<0.01);K组气管插管时、手术开始时的IOP与麻醉前相比均有升高(P<0.05),两组相应时点的IOP相比较均有显著差异(P<0.05)。PK组的恶性呕吐发生率明显低于K组(P<0.01),清醒时间亦明显短于K组(P<0.01)。结论 丙泊酚复合小剂量氯胺酮用于小儿眼科手术不仅可产生良好的临床麻醉效果,保持围术期血流动力学稳定,而且术后恶心、呕吐发生率低,术后恢复迅速且质量高。
Objective To observe the effects of propofol combined with low-dose ketamine on hemodynamics in children during ophthalmologic operation and the results of postoperative recovery. Methods Sixty ASAⅠ -Ⅱ children scheduled for ophthalmologic operation were randomly assigned to two groups: propofol combined with low-dose ketamine group (group PK, n = 30) and ketamine group (group K, n = 30). MAP, HR and intraocular pressure (IOP) were determined. Awake time and postoperative nausea vomiting (PONV) were assessed after operation. Results In group K, MAP and HR were increased significantly after intubation, at skin incision, 15 min after operation and at the end of operation (P<0.05 or P<0.01). MAP and HR were lower after intubation, at skin incision, 15 min after operation and at the end of operation in group PK than those in group K (P<0.01 ). In group K, IOP was increased significantly after intubation, at skin incision (P<0.05). IOP was lower after intubation, at skin incision in group PK than those in group K (P<0.05). The incidence of PONV in group PK was lower than that in group K (P<0.01). Awake time in group K was significantly longer than that in group PK (P<0.01). Conclusion Propofol combined with low-dose ketamine anesthesia is effective in keeping the stability of hemodynamics, making awake quickly and reducing the occurrence of PONV in pediatric ophthalmologic operation.
出处
《华中医学杂志》
2003年第5期259-260,264,共3页
Central China Medical Journal
关键词
丙泊酚
氯胺酮
小儿眼科手术
临床研究
血流动力学
麻醉效果
Propofol Ketamine Hemodynamics Postoperative nausea vomiting Child ophthalmologic operation
