氯胺酮复合异丙酚静脉全麻在小儿先天性心脏病介入治疗中的应用及对心钠素的影响

The application of ketamine combined with propofol anesthesia in intervention therapy for infantile congenital heart disease and its effect on atrial natriuretic peptide

目的研究氯胺酮复合异丙酚静脉全麻在小儿先天性心脏病介入治疗中的安全性和有效性及对心钠素(atrial natriuretic peptide,ANP)的影响。方法选择美国麻醉医师协会(ASA)Ⅰ~Ⅱ级小儿先天性心脏病介入治疗患儿40例,年龄2~7岁,体重11~25kg。随机分为2组,每组各20例。氯胺酮组为持续泵注氯胺酮,异丙酚组为持续泵注异丙酚。测定入室后(T1)、麻醉维持15min(T2)时ANP浓度,并同时记录心率、血氧饱和度(SpO2)。结果氯胺酮组有2例一过性呼吸抑制,异丙酚组有1例,经托下颌面罩吸氧缓解,2组间SpO2差异无统计学意义(P>0.05)。心率和ANP变化一致,氯胺酮组在T2高于T1(P<0.05),异丙酚组变化不明显,2组间比较氯胺酮组在T2高于异丙酚组(P<0.05)。结论异丙酚对ANP影响不明显,氯胺酮复合异丙酚静脉全麻是小儿先天性心脏病介入治疗手术的一种较好的麻醉方法。

Objective To assess the safety and efficacy of continuous intravenous administration with ketamine combined with propofol for children undergoing cardiac catheterization procedures and its effect on atrial natriuretic peptide(ANP).Methods Forty ASA I orⅡchildren in transcatheter closure of congenita heart disease,aged 2 yr～7 yr,weighing 11～25 kg,were randomly divided into 2 groups(n=20 in each group).ketamine group received ketamine for maintenance of anesthesia,however,propofol group received propofol.The ...