小剂量氯胺酮用于瑞芬太尼全麻患者苏醒期清醒无痛拔管

Effect of Low Dose Ketamine on Making Extubation Comfortable and Painless during the Recovery Period from Remifentanil-based General Anesthesia

目的探讨小剂量氯胺酮用于瑞芬太尼全麻患者苏醒期清醒、无痛拔管的效果。方法选择ASAⅠ~Ⅱ级行腹腔镜检和宫腹腔镜检手术患者60例,随机分为两组(n=30):Ⅰ组,手术近结束缝合皮肤时静脉注射氯胺酮0.5 mg/kg,术毕停用瑞芬太尼;Ⅱ组,术毕停用瑞芬太尼。比较两组苏醒期有无呛咳、躁动,呼唤睁眼时间、拔管时间,术前(T0)、术毕(T1)、拔管即刻(T2)、拔管后5 m in(T3)血压、心率以及T2、T3时VRS评分。结果①Ⅰ组患者呛咳、躁动发生率均明显低于Ⅱ组(P<0.01);②Ⅰ组呼唤睁眼时间和拔管时间均比Ⅱ组稍延长,但无统计学差异(P>0.05);③Ⅰ组T2、T3时BP和HR均低于Ⅱ组(P<0.01),VRS评分亦低于Ⅱ组(P<0.05)。结论手术近结束时应用小剂量氯胺酮有利于瑞芬太尼全麻患者在苏醒期清醒、无痛、安全地拔管。

Objective To study the effect of low dose ketamine on making comfortable and painless during the recovery period from remifentanil-based general anaesthesia.Methods Sixty female adult patients with ASA grade I to Ⅱ who undergone the hysteroscopy and laparoscopy were randomized into two groups,with 30 patients for each.Remifentanil(1μg/kg),propofol(2 mg/kg) and vecuronium(0.1 mg/kg) were administered for anesthesia induction,and 0.2～0.25μg/(kg·min) remifentanil and 1%～1.5% isoflurane were given for anesthesi...