氯瑞合剂对小儿全身静脉麻醉心血管系统的影响

The Effect of Remifentanil on Cardiovascular System in Pediatric General Anesthesia

目的：观察瑞芬太尼复合氯胺酮在小儿全身麻醉中对心血管系统的影响。方法：将80例ASAⅠ级～Ⅱ级患儿随机分为A、B两组，每组各40例。A组用氯胺酮静脉注射泵维持，B组用氯胺酮以及瑞芬太尼静脉注射泵维持。术中监测患儿血压、心率及SpO2，观察并记录术后苏醒时间和氯胺酮的用量。结果：A组患儿血压和心率与麻醉前相比差异有显著性（P〈0．05），B组差异无显著性，两组患儿SpO2较麻醉前差异均无显著性；B组术中氯胺酮用量和复苏时间均明显少于A组（P〈0．05）。结论：瑞芬太尼复合氯胺酮用于小儿全身麻醉能更有效地维持心血管系统稳定，是一种较安全的麻醉方法。

Objective To study the effect of remifentanil and ketamine on cardiovascular system in pediatric general anesthesia. Methods Eighty patients were divided into two groups randomly. Group A was maintained with continuous infusion of ketamine intravenously, and group B was maintained with remifentanil and ketamine pumping. The mean blood pressure, heart rate, and SpO2 were recorded perioperatively. The time of recovery from anesthesia and dosage of ketamine were also recorded. Results The mean blood pressure and heart rate in group A were higher significantly in and after operation than preoperative state. There was no difference of SpO2 in both groups perioperatively. The dosage of ketamine and recovery time were higher in group A than that in group B. Conclusion The anesthesia maintained with remifentanil and ketamine was more effective in keeping cardiovascular system stable, and more safer in pediatric general anesthesia.