乳腺瘤切除术中不同剂量氯胺酮静脉复合麻醉效果比较

Comparison of the effect of different doses of ketamine used in intravenous anesthesia for breast tumor resection

目的比较乳腺瘤切除术中3种不同剂量氯胺酮静脉复合麻醉的效果,探讨此类手术氯胺酮静脉复合麻醉的最佳剂量。方法153例ASAⅠ～Ⅱ级乳腺瘤患者分为3组,氯胺酮用量分别为A组(51例)0.5mg/kg、B组(51例)0.8mg/kg、C组(51例)1mg/kg,3组麻醉中均辅用相同剂量的丙泊酚、咪唑安定和芬太尼。术中监测血压(BP)、心率(HR)、血氧饱和度(SpO2)、心电监护(ECG),比较术中患者呼吸、循环稳定性及麻醉清醒时间与不良反应。结果A、B组切皮后5分钟和10分钟的SBP、MBP、HR及术后清醒时间、质量与C组比较,差异均有统计学意义(P<0.01)。结论氯胺酮0.5mg/kg及0.8mg/kg复合丙泊酚、咪唑安定、芬太尼用于乳腺瘤切除术,不良反应小,麻醉效果确切,清醒时间短,质量高,更适合临床麻醉选择。

Objective To compare the anesthetic effect of three different doses of ketamine used in intravenous anesthesia for breast tumor resection,so as to find the best dosage for ketamine used in this type of surgeries.Methods 153 cases of ASAⅠⅡ breast tumor were randomly divided into group A,B and C.Ketamine was used in a dose of 0.5 mg/kg,0.8 mg/kg and 1 mg/kg respectively,adding the same dose of narcotic propofol,midazolam and fentanyl.Intraoperative monitoring of BP,HR,SPO2 and ECG were carried out.Respiratory,stability of circulation,anesthesia awake time and adverse reactionf of the three groups were compared at the same time.Results There were statistically significant differences （P 〈 0.05） between the Results of SBP,MBP and HR （5 and 10 minutes after operation） in group A and group C.There were statistically significant differences （P 〈 0.05） between the Results of SBP,MBP and HR （5 and 10 minutes after operation） in group B and group C.The postoperative awake time of group A and B were shorter than that of group C.The differences were significant （P 〈 0.01）.The conscious quality of group A and B was better than that of group C.The differences were significant （P 〈 0.01）.Conclusion Ketamine of 0.5 mg/kg and 0.8 mg/kg with propofol,midazolam and fentanyl are more suitable for clinical anesthesia in breast tumor resection due to their small adverse reaction,exact anesthetic effect,short awake time and high quality.