摘要
目的评价艾司氯胺酮复合丙泊酚用于患儿MRI检查的镇静效果。方法选择2021年2至6月行MRI检查的患儿100例,性别不限,年龄1~6岁,体重10~30 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组(n=50):丙泊酚组(P组)和艾司氯胺酮+丙泊酚组(K+P组)。麻醉诱导:P组静脉注射丙泊酚2.5 mg/kg,K+P组静脉注射艾司氯胺酮0.5 mg/kg和丙泊酚1.5 mg/kg;麻醉维持:静脉泵注丙泊酚100μg·kg^(-1)·min^(-1),调节丙泊酚输注速率,维持Ramsay镇静评分≥5分。发生中重度体动反应时,静脉注射丙泊酚0.5~1.0 mg/kg和(或)增加丙泊酚输注速率。评估检查过程中MRI图像质量,记录体动反应发生情况及其程度、气道相关不良事件(低氧血症、窒息、上呼吸道梗阻、分泌物增多)及低血压、心动过缓的发生情况;记丙泊酚平均输注速率、静脉追加量及总用量。记录苏醒时间和麻醉恢复室停留时间;记录恢复室观察期间不良事件(呕吐、复视及躁动)发生情况和家属对镇静效果和恢复的满意度。结果与P组相比,K+P组丙泊酚平均输注速率和总用量、气道相关不良事件及低血压、心动过缓的发生率降低(P<0.05),体动反应发生率及其程度、MRI图像质量、苏醒时间、麻醉恢复室停留时间及恢复期间不良事件发生率差异无统计学意义(P>0.05)。结论艾司氯胺酮复合丙泊酚可安全、有效地用于患儿MRI检查镇静。
Objective To evaluate the sedative efficacy of S-ketamine combined with propofol for MRI examination in pediatric patients.Methods One hundred children of both sexes,aged 1-6 yr,weighing 10-30 kg,of American Society of Anesthesiologists physical statusⅠorⅡ,who underwent MRI from February to June 2021,were selected and divided into 2 groups(n=50 each)by a random number table method:propofol group(P group)and S-ketamine plus propofol group(K+P group).Anesthesia induction:propofol 2.5 mg/kg was intravenously injected in group P,and S-ketamine 0.5 mg/kg and propofol 1.5 mg/kg were intravenously injected in group K+P.Anesthesia maintenance:propofol 100μg·kg^(-1)·min^(-1)was intravenously infused,and the infusion rate of propofol was adjusted to maintain Ramsay sedation score≥5.Propofol 0.5^(-1).0 mg/kg was intravenously injected and/or increasing the infusion rate of propofol when moderate and severe movement occurred.The quality of MRI images was evaluated during the examination,and the occurrence and degree of movement,airway-related adverse events(hypoxemia,apnea,upper airway obstruction,hypersalivation),hypotension and bradycardia were recorded.The average infusion rate,consumption of additional propofol for intravenous administration and total consumption of propofol were recorded.The emergence time and time of anesthesia recovery room stay were recorded.The occurrence of adverse events(vomiting,diplopia and agitation)and the parents′satisfaction with sedative efficacy and recovery were recorded during observation in the recovery room.Results Compared with group P,the average infusion rate of propofol,total consumption of propofol,airway-related adverse events and incidence of hypotension and bradycardia were significantly decreased(P<0.05),and no significant change was found in the incidence and degree of body movement,quality of MRI images,emergence time and time of anesthesia recovery room stay and incidence of adverse events during recovery from anesthesia in group K+P(P>0.05).Conclusion S-ketamine combined with propofol can be safely and effectively used in MRI examination in pediatric patients.
作者
刘玉静
邢飞
王绪林
张彤彤
渠明翠
杨建军
邢娜
Liu Yujing;Xing Fei;Wang Xulin;Zhang Tongtong;Qu Mingcui;Yang Jianjun;Xing Na(Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2021年第9期1120-1123,共4页
Chinese Journal of Anesthesiology
关键词
氯胺酮
二异丙酚
儿童
磁共振成像
Ketamine
Propofol
Children
Magnetic resonance imaging
作者简介
通信作者:邢娜,Email:16427485@qq.com。
