异丙酚氯胺酮麻醉对自主通气的影响及氧治疗

SPONTANEOUS RESPIRATION EFFECTS AND OXYGEN TREATMENT DURING COMBINED INTRAVENOUS PROPOFOL AND KETAMINE ANESTHESIA

目的：通过观察静脉异丙酚氯胺酮复合保留自主呼吸麻醉中的血气、ＳｐＯ２的变化，为此种麻醉方法在临床应用提供资料。方法：选择２０例口腔、颌面部手术病例，采用静脉异丙酚＋氯胺酮复合保留自主呼吸全麻。术前、术中监测血气，全程监测ＳｐＯ２。结果：发现存在不同程度的低氧血症，诱导后ＰａＯ２下降，ＰａＣＯ２增高，ＳｐＯ２及呼吸频率（ＲＲ）均下降，维持期不吸氧时ＳｐＯ２及ＲＲ亦均下降，诱导后和维持期吸氧后ＳｐＯ２回升，插管后经气管导管开放式给氧行氧治疗，吸氧的氧流量成人４Ｌ／ｍｉｎＳｐＯ２回升最高。此种麻醉维持方法，术中血流动力学平稳，苏醒迅速、彻底，麻醉效果确切。结论：此种麻醉方法。

Objective:To observe the changes of Blood gas、SpO 2 during combined intravenous propofol and Ketamine anesthesia with spontaneous respiration for clinical use of this anesthesia method Methods:Twenty patients underwent oromaxillary operation were studied Anesthesia were maintained with combined intravenous propofol and Ketamine,autonomous respiration were repeated Blood gas analysis and SpO 2 were monited pre and during operation Results:Data showed that different Level of hypoxemia existed during anesthesia PaO 2 decreased,PaCO 2 increased after induction,and SpO 2、RR decreased at the same time SpO 2 and RR decreased significantly during anesthesia if no oxygen were supplied while kept normal if oxygen were supplied through endotrached catheter SpO 2 at perfect level when oxygen flow were 4L/min in adult patient,This anesthesia can keep hymodynamic stable,recovering rapidly Conclusion:This anesthesia is suitable for oromaxillary operation