摘要
目的观察丙泊酚复合氯胺酮应用于小儿眼科手术麻醉时对呼吸循环的影响及麻醉恢复情况,并与单纯氯胺酮作比较,探讨一种较为理想的复合用药方法。方法择期行眼科手术的患儿40例,采用随机数字表法分为2组:A组20例,肌注氯胺酮6.0～8.0mg/kg,术中酌情静脉追加氯胺酮1.0～2.0mg·kg-1/次;B组20例,肌注氯胺酮2.0～3.0mg/kg,并于手术开始前2min静脉注射丙泊酚1mg/kg,后以氯胺酮1.5～2.5mg/(kg·h)和丙泊酚6～10mg/(kg·h)持续静脉微泵输注,术毕前5min同时停用。监测心率(HR)、平均动脉压(MAP)、RR及SPO2的变化,并记录氯胺酮的用量、术后的清醒情况及恶心呕吐的发生率。结果A组患儿的MAP、HR在手术开始后明显高于基础值(P<0.05);B组患儿在手术开始时MAP和HR较基础值稍有增加(P<0.05),但术中渐降至术前水平或稍低,并保持平稳至术毕;两组患儿的SPO2和RR与基础值相比无显著差异。B组术中氯胺酮的用量和清醒时间明显少于A组,呼吸抑制和术后呕吐发生率亦明显低于A组(P<0.01)。结论与单纯氯胺酮相比,丙泊酚复合氯胺酮能更好的保持呼吸循环稳定,缩短术后清醒时间,减少恶心呕吐的发生,是一种较理想的小儿眼科手术麻醉方法。
Aim To study the effect of propofol combined with ketamine for anesthesia of ophthalmic surgery of children, compared with ketamine. Methods 40 children for ophthalmic surgery, were randomly divided into A group(n=20) and B group(n=20).In A group, children were administrated ketamine of 6-8 mg/kg intramuscularly before operation, and small dose of ketamine was added intravenously if needed.In B group,children were administrated ketamine 2-3 mg/kg intramuscularly before venipuncture, and then,were injected propofol of 1mg/kg intravenously 2min before operation followed by continuous administration of 1.5-2.5 mg/(kg·h) of ketamine and 6-10 mg/(kg·h) of propofol by infusion pump. HR, MAP, RR and SPO2 were monitored, the dose of ketamine,the incidence of nausea and vomiting and awakening condition were also observed.Results Compared with administrate ketamine only,propofol combined with ketamine can maintain the stability of respiration and circulation better.The total dose of ketamine of A group was more than B group, and the awakening time in A group was also longer than B group (P< 0.01). The incidence of respiratory depression and vomiting of A group was higher than B group(P< 0.01).Conclusions Propofol combined with ketamine for anesthesia of ophthalmic surgery of children can keep respiration and circulation steady, shorten the awakening time and reduce the incidence of vomiting.
出处
《中国临床康复》
CSCD
2003年第14期2124-2125,共2页
Chinese Journal of Clinical Rehabilitation
