氯胺酮联合硬膜外麻醉用于腹腔镜胆囊切除术的疗效研究

Intravenous ketamine combined with epidural anesthesia for laparoscopic cholecystectomy

目的:观察探讨氯胺酮联合硬膜外麻醉用于腹腔镜胆囊切除术的效果及安全性。方法:检测分析氯胺酮联合硬膜外麻醉(氯胺酮组,n=40)和单纯硬膜外麻醉(对照组,n=40)行腹腔镜胆囊切除术的麻醉效果、平均动脉压、心率、血氧饱和度以及动脉血PaO2和PaCO2的差异。结果:氯胺酮组患者术中麻醉效果明显好于对照组(P<0.01),平均动脉压、心率较对照组稳定(P<0.01,P<0.001),血氧饱和度、动脉血PaO2、PaCO2与对照组比较,差异均无统计学意义(P>0.05)。结论:氯胺酮可弥补硬膜外麻醉在腹腔镜手术中的不足,临床应用安全有效。

Objective： To observe the response and safety of intravenous ketamine combined with epidural anesthesia on laparoscopic cholecystectomy. Method： In this study, 40 patients undergoing laparoscopic cholecystectomies were anesthetized with epidural anesthesia（control group） and the other 40 patients were anesthetized with intravenous ketamine combined with epidural anesthesia（ketamine group）. The response to anesthesia and the changes of mean blood pressure（MAP）, heart rate（HR）, SPO2 as well as PaO2 and PaCO2 were observed. Results： The anesthesia effect of the ketamine group was better than that of the control group. The MAP and HR in the ketamine group were more stable than in the control group and there were no statistical differences in PaO2 and PaCO2 between the two groups. Condusion： Administration of ketamine is beneficial to epidural anesthesia in laparoscopic cholecystectomy, This method can be used safely and effectively in clinical cases.