阈下氯胺酮复合强效镇痛药及咪唑安定用于静脉麻醉

Intravenous anesthesia by the combination of subdissociative doses of ketamine, midazolam and potent narcotics.

３０例拟在全麻下行择期手术的患者随机分为三组。Ｆ组用阈下氯胺酮、咪唑安定和芬太尼维持麻醉，Ｓ组和Ｄ组分别用舒芬太尼和二氢埃托啡代替芬太尼。实验结果显示，三组患者麻醉中血压、心率保持稳定，在机械通气的条件下，心排血量、每搏量有所降低。手术后患者意识能较快恢复，Ｓ组平均于术后６．５分、Ｆ组８．６分、Ｄ组１２．８分达拔管标准。术后随访除一例患者（Ｄ组）认为麻醉尚可外，余皆表示满意。结果表明本组静脉麻醉方法安全、有效、实用。

Thirty patients, randomly assigned into three groups, received bolus injection of ketamine 0. 5mg/ kg,midazolam 40ug/kg and one of the three narcotics: fentanyl 3ug/kg (group F ) or sufentanil 0. 4ug/kg (group S)or dihydroetorphine 0. 3ug/kg(group D)just before incision, and then a constant infusion of ketamine 0. 8mg/kg, midazolam 40ug/kg and fentanyl 3ug/kg (or sufentanil 0. 4ug/kg, or dihydroetorphine 0. 3ug/kg)mixture in 100ml normal saline at a rate of 3ml/min for 30 min in beginning, and 1 - 1. 5ml/min thereafter for maintenance. The infusion of narcotics and midazolam was terminated about 45min, and he tamine 15min prior to the end of surgery. Blood pressure and heart rate were all stable,with recovery time shortest in group S (6. 5min ) and longest in group D (12. 5min). Anesthesia were satisfactory in all the patients,except one in group D. It is concluded that this combination of tv anesthetics may be simple and effective and can be considered as an alternative anesthesia technique in the management of mass casualties.