雷米芬太尼和氯胺酮复合异丙酚在小儿静脉麻醉效果的比较

A Comparison of Remifentanil-propofol and Ketamine-propofol Anesthesia in Pediatric Intravenous Anesthesia

目的:比较不同剂量的雷米芬太尼和氯胺酮复合异丙酚在小儿全凭静脉中诱导、维持苏醒的效果。方法:选择60例ASAⅠ级~Ⅱ级手术患儿随机分成四组,R1、R2分别以雷米芬太尼2μg/kg、3μg/kg,K1、K2分别以氯胺胴3mg/kg、4mg/kg,4组均以异丙酚2mg/kg、阿曲库铵0.6mg/kg作诱导。术中,R1、R2组维持以雷米芬太尼10μg/(kg.h),12μg/(kg.h),K1、K2组以氯胺胴2mg/(kg.h)、3mg/(kg.h),异丙酚4mg/(kg.h),不定期予阿曲库铵维持肌松,记录麻醉前(基础值)T0,插管前即刻T1,插管后1′T2,3′T3,术毕前T4的Map、Hr、Bis。另记录术后呼吸恢复时间、睁眼时间、拔管时间,计算术中维持剂量。结果:R2组诱导平稳,其他三组有不同程度的血流动力学改变,麻醉维持时,Bis在R2组中同另外三组同期比较有统计学意义。R1、R2组在呼吸恢复时间、睁眼时间、拔管时间上与K1、K2组相比差异有显著性。结论:雷米芬太尼同氯胺酮相比,在麻醉效果、安全性、血流动力学方面是一种更优的镇痛药。

Objective To compare the effect of different doses of remifentanil-propofol or ketamine-propofol anesthesia in pediatric intravenous anesthesia.Methods sixty ASA classⅠorⅡin fant palients aged littler ten year were randomly assigned to four equal groups receiving targef-controlled in fusion of remifentanil-propofol(R1,R2group)or ketamine-propofol(K1,K2 group).The anesthesia was carried out with Remifentanil 2 mg/kg,and 3 mg/kg,ketamine 3 mg/kg,4 mg/kg differently in R1,R2,K1,K2 group and Atracurium 0.6 mg/k...