摘要
目的:比较布托啡诺或芬太尼联合丙泊酚与小剂量氯胺酮在乳腺区段手术中的麻醉效果。方法:选择80例择期行乳腺手术的患者,随机均分为布托啡诺组(A组)和芬太尼组(B组),所有患者均选择静脉麻醉。A组患者手术开始前5min加管快速滴入布托啡诺15μg/kg,B组患者手术开始前5min加管快速滴入芬太尼1.5μg/kg,两组患者丙泊酚诱导剂量均为1mg/kg(4ml/10s),以4mg(/kg.h)恒速静脉泵入维持麻醉,并于术前1min静脉注射氯胺酮0.5～1.0mg/kg,术中酌情追加氯胺酮。记录不同时段患者的循环体征和呼吸参数,同时记录不良反应发生情况及药物用量。结果:在麻醉深度相同的情况下,两组患者血压、脉搏差异无统计学意义(P>0.05)。两组患者的1～5min通气量均显著低于基础值,而B组患者的这一趋势更加显著(P<0.05)。B组患者发生的呼吸系统不良反应率显著高于A组患者(P<0.05)。结论:两种药物配比麻醉方案均可让手术患者在乳腺区段手术中取得较满意的麻醉效果。但布托啡诺引发的呼吸抑制作用更少,且对自主呼吸抑制较轻微,不良反应少,更为安全,更适用于乳腺区段手术等短小手术。
OBJECTIVE： To explore the application of butorphanol or fentanyl combined with propofol and small dose of ketamine in segmental mastectomy during intravenous anesthesia. METHODS： 80 patients underwent elective segmental mastectomy, were randomly divided into butorphanol （group A） and fentanyl group （group 13） with intravenous anesthesia. Butorphanol 15 gg/kg dropped into the tube rapidly in group A and fentanyl 1.5μg/kg in group B 5 min before surgery. The dose of propofol induc- ing anesthesia was 1 mg/kg （4 ml/10 s） in 2 groups, maintaining anesthesia with constant speed pump at 4 mg/（kg-h） ; ketamine 0.5-1.0 mg/kg was injected 1 min before operation, giving supplementary dose during operation as often as needed. The signs of circulation and respiratory parameters were recorded at different time points, at the same time drug dosage and ADR were also record- ed. RESULTS： With the same depth of anesthesia, the differences of blood pressure and pulse between 2 groups had no statistical significance （P〉0.05）. 1-5 min ventilations were significantly lower than basic value in both groups, and more apparent in group B （P〈0.05）. The occurrence of respiratory ADR in group B was significantly higher than in group A（P〈0.05）. CONCLUSION： 2 kinds of anesthesia scheme can obtain satisfied anaesthetic effect during segmental mastectomy. Butorphanol cause less respiratory inhibition than fentanyl and induce slight depression of dependent respiratory and less ADR with more security; it is more suitable for minor surgery as segmental mastectomy.
出处
《中国药房》
CAS
CSCD
2013年第16期1497-1499,共3页
China Pharmacy
关键词
布托啡诺
芬太尼
异丙酚
氯胺酮
静脉麻醉
乳腺区段手术
Butorphanol
Fentanyl
Propofol
Ketamine
Intravenous anesthesia
Segmental mastectomy
作者简介
主治医师，本科。研究方向：临床麻醉。电话：0931-2302815。E-mail：whd19771010@163．com
通信作者：主任医师。研究方向：临床麻醉。E-mail：whd19771010@163．com
