瑞芬太尼与氯胺酮用于剖宫产全麻时对血压、心率及胎儿评分影响的比较

Effects of Remifentanly and Ketamin on Parturient Blood Pressure,Heart Rate and Neonate Apgar Score

目的:对照研究在全麻剖宫产术中应用瑞芬太尼和氯胺酮诱导对母婴的影响。方法:选择100例禁忌椎管内麻醉而须行全麻剖宫产手术的患者,分为两组,氯胺酮组静注异丙酚1.5 mg/kg+氯胺酮1 mg/kg+琥珀胆碱1.5 mg/kg;瑞芬太尼组静注异丙酚1.5 mg/kg+瑞芬太尼1μg/kg+琥珀胆碱1.5 mg/kg诱导插管,胎儿娩出后均静注芬太尼2 g/kg、泵注异丙酚3 mg/(kg.h)和吸入异氟醚0.5MAC维持麻醉,阿曲库铵维持肌松。结果:瑞芬太尼组插管(切皮)后血压、心率升高幅度显著小于氯胺酮组,两组新生儿1 min、5 min Apgar评分无明显差异。结论:瑞芬太尼用于产科全麻优于氯胺酮,安全可行。

Objective：To compare the effects of remifentanyl with ketamin on parturients and neonates used in general aneasthesia in cesarean resections.Methods：One hundred parturients contraindicated intraspinal anaesthesia undergoing cesarean resection were divided into two groups.In group Ⅰ anaesthesia was induced with propofol 1.5 mg/kg＋ketamin 1 mg/kg＋scolin 1.5 mg/kg and group Ⅱ with propofol 1.5 mg/kg＋remifentanyl 1.51 μg/kg ＋scolin 1.5 mg/kg.Anaesthesia were maintained with fentanly,propofol,atracurium and inhalation of 0.5MAC sevofluren in both groups. Results： Increases of blood pressure and heart rate were significantly lower in group Ⅱ than in group Ⅰ （P〈0.05）. There was no significant difference of 1 min and 5 min Apgar scores of neonate between two groups. Conclusion： Remifentanyl is better than ketanmine and can be safely used in general aneasthesia in ceasarin resections.