氯胺酮复合异丙酚麻醉用于先天性心脏病介入术85例

Ketamine-Propofol Mixture Anesthesia for 85 Children with Congenital Heart Disease Undergoing Cardiac Catheterization

目的评价氯胺酮复合异丙酚麻醉应用于经皮小儿先天性心脏病介入治疗的安全性和可行性。方法 85例拟行先天性心脏病介入治疗的患儿随机分为氯胺酮组(K组,n=44)和氯胺酮复合异丙酚组(KP组,n=41)。K组:静脉注射氯胺酮1mg.kg-1后以50μg.kg-1.min-1输注维持。KP组:静脉注射氯胺酮1mg·kg-1+异丙酚1mg·kg-1,之后氯胺酮16.7μg.kg-1.min-1+异丙酚33.3μg.kg-1.min-1输注。连续监测心电图、血压、脉搏、呼吸频率、血氧饱和度,并记录苏醒时间。结果二组患儿血流动力学及呼吸功能稳定。K组氯胺酮用量[(52.1±2.8)μg.kg-1.min-1]显著高于KP组[(25.3±7.3)μg.kg-1.min-1],KP组睁眼时间和完全清醒时间分别为(9.8±5.7)min和(40.4±18.3)min,K组睁眼时间和完全清醒时间分别为(11.2±1.0)min和(50.2±16.5)min。二者比较,差异有统计学意义。结论氯胺酮复合异丙酚用于经皮小儿先天性心脏病介入封堵麻醉安全、平稳,患儿苏醒快。

Objective To evaluate the safety and feasibility of ketamine - propofol mixture anesthesia for 85 children with congenital heart disease undergoing cardiac catheterization. Methods Eighty - five children with congenital heart disease undergoing cardiac cathete- rization were randomly divided into ketamine group（ K group, n = 44 ） and ketamin -propofol group（ KP group, n = 41 ）. K group：1mg · kg^-1 ketamine was injected intravenously and then infused at 50ug·kg^-1·min^-1 for anesthesia maintenance. KP group： anesthesia was induced with ketamine 1 mg·kg^-1 and propofol 1 mg ·kg^-1 intravenously, and maintained by continuous infusion of ketamine （16.7ug·kg^-1·min^-1） and propofol （ 33.3ug·kg^-1·min^-1）. Electrocardiogram, blood pressure, pluse, respiratory frequency, saturation of blood oxygen were continously monitored. Results Hemodynamic and respiratory function were stable in both 2 groups. Ketamine consumption in K group was significantly more than that in KP group[ （52.1±2.8） ug·kg^-1·min^-1 vs （25.3 ±7.3 ） ug·kg^-1·min^-1] ,eye opening time and recovery time were also longer in K group than those in KP group [ （50.2 ± 16.5 ） rain vs （40.4 ± 18, 3 ） min ]. Conclusion The ketamine - propofol mixture was a safe, efficacy anesthesia with excellent recovery in children with congenital heart disease undergoing cardiac catheterization.