硬膜外阻滞上腹部手术时辅用哌替啶异丙嗪合剂和氯胺酮对通气功能的抑制

Ventilatory Inhibition of Pethidine-Phenergan and Ketamine during Epidural Block in Upper Abdominal Operation

通过40例硬膜外阻滞上腹部手术病人辅用哌异合剂和氯胺酮后通气指标的观察证明,辅用哌异合剂后导致普遍呼吸抑制(P<0.01),甲组RR、V_T、V_E和V_A分别下降2.6%、32.5%、35.2%和47.3%。减少药量(乙组),RR虽有增加,V_E下降(24.4%)相对减轻,但V_A的降低(41.3%)仍较严重。辅用少量氯胺酮后,两组均未发现通气指标进一步降低(P>0.05),血气分析也变化不大。文章就此做了分析,并提出临床使用意见。

The effects of Pethidine-Phenergan (P-Ph) and Ketamine (KTM) on the ventilation in 40 patients under epidural block for upper abdominal operation. were studied. The parameters of ventilation showed that after infusing P-Ph. inhibition of ventilation was evident (P<0.01). RR, V_T, V_E and V_A decreased by 2. 6% , 32.5%.35. 2% and 47.3% respectively in the group A (n=18). RR increased and V_E merely decreased by 24. 4% after lowering of dosage (group B, n=22), but it was still severe enough with V_A decreased 41. 8%. The indeces of ventilation of both groups not decreased further after infusing of small dose KTM (P>0.05), analysis of arterial blood gases was not significant.