小剂量氯胺酮对老年人全麻诱导气管插管期心血管反应的影响

THE EFFECT OF LITTLE DOSE of KETAMINE ON CARDIOVASCULAR RESPONSE OF THE ELDERLY TO TRACHEAL INTUBATION AFTER INDUCTION

目的观察小剂量氯胺酮对老年人全麻诱导气管插管期心血管反应的影响。方法选择80例拟行全麻择期手术老年患者,随机分为两组:小剂量氯胺酮(0.3 mg/Kg)+丙泊酚(1.8mg/Kg)诱导组(KP组);丙泊酚诱导组(P组)。记录两组患者在诱导前(T0)、诱导后气管插管前(T1)、气管插管时(T2)、插管后1min(T3)、插管后3min(T4)、插管后5min(T5)时间点的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)的变化。结果KP组组间SBP、MAP、DBP和HR变化有显著性(P<0.05);P组组间SBP、MAP、DBP和HR变化有显著性(P<0.05);KP组与P组比较,T1、T2和T3时点的SBP、MAP、DBP、HR的变化均有显著性(P<0.05)。结论小剂量氯胺酮能够有效减低老年人全麻诱导期气管插管的心血管反应。

Objective To discuss effect of little dose of ketamine on cardiovascular responses of elderly to tracheal intubation.Methods 80 elderly patients scheduled for undergoing surgery by general anesthesia were randomly assigned into two groups.Anesthesia induction in KP group was given little dose Ketamine（0.3mg/Kg）＋ Propofol（1.8mg/kg）.Anesthesia induction in P group was given Propofol（1.8mg/kg）.Record the SBP,DBP,MAP,HR＇s changes of the two groups before induction（T0）.After induction,before tracheal intubation（T1）,immediately after tracheal intubation（T2）,1min（T3）,3min（T4） and 5min（T5） after intubation.Results SBP,MAP,DBP and HR of the patients changed significantly in group KP（P〈0.05）;SBP,MAP,DBP and HR of the patients changed significantly in group P（P〈0.05）;T1,T2and T3 of SBP,MAP,DBP and HR changed significantly between group KP and group P.Conclusion The little dose of ketamine can significantly relieve the cardiovascular response of the elderly patients under anesthesia induction.