瑞芬太尼复合氯胺酮在小儿全凭静脉麻醉中的应用

The application of remifentanil combined with ketamine in intravenous general anesthesia of children.

目的探讨瑞芬太尼复合氯胺酮用于小儿全身麻醉的临床疗效。方法将60例ASAⅠ～Ⅱ级患儿随机分为K(氯胺酮)、R(瑞芬太尼)两组,每组各30例。两组均静脉单次推注氯胺酮2mg/kg,K组:氯胺酮10～25μg/(kg·min)维持;R组:瑞芬太尼0.08～0.12μg/(kg·min)持续泵注。术中监测患儿血压、心率及SpO2,记录术中苏醒时间和不良反应。结果K、R两组患者SpO2均较平稳,但R组心率较术前明显减慢,而K组心率和血压较术前明显增加;R组术后麻醉苏醒明显快于K组。结论瑞芬太尼复合氯胺酮用于小儿全凭静脉麻醉既满足手术需要,又降低并发症发生率,使患儿麻醉苏醒时间明显缩短,麻醉更平稳。

Objective To investigate the clinical effects of the application of remifentanil combined with ketamine in intravenous general anesthesia of children. Methods 60 children of ASA Ⅰ - Ⅱ were randomly divided into two groups： K（ ketamine ） group（ n = 30） ; R （ remifentanil ） group （ n = 30 ）. Ketamine （2mg/kg） was administered intravenously by single bolus. Maintainance of anesthesia was achieved by ketamine 10 - 25μg/（ kg· min ） in K group, remifentanil 0. 08 - 0.12μg/（ kg· min ） in R group, with syringe pumps. Blood pressure, heart rate and SpO2 were monitored during operation. The time to regain consciousness and all adverse reactions were recorded post-operation. Results SpO2 were steady in both groups. Compared with pre-operafion, the heart rates in R group were much slower, however, the heart rates and blood pressure in K group were increased obviously. The time to regain consciousness was significantly shorter in R group than that in K group. Conclusion The application of remifentanil combined with ketamine in intravenous general anesthesia of children can meet the needs of operation with less complication,shorter time to regain consciousness and steadier anesthesia .