瑞芬太尼复合氯胺酮用于小儿全静脉麻醉的临床观察

Remifentanil combined with ketamine for general anaesthesia in children

目的探讨瑞芬太尼复合氯胺酮用于小儿全麻醉的临床疗效。方法将80例ASAⅠ～Ⅱ级患儿随机分为A、B两组,每组各40例。两组均静脉给予咪唑安定0.02mg.kg-1,单次推注氯胺酮2mg·kg-1,A组:氯胺酮95μg/(kg·min)持续泵注维持;B组:氯胺酮58μg/(kg·min)配合瑞芬太尼0.06μg/(kg·min)持续泵注。术中监测患儿血压、心率,及SPO2,并记录术后苏醒时间。结果 A、B两组患儿血压和SPO2均较平稳,但B组心率较术前明显减慢(P<0.05),而A组心率较术前明显增快(P<0.05),B组术后麻醉苏醒明显快于A组(P<0.05),且术中氯胺酮用量明显少于A组(P<0.05)。结论瑞芬太尼复合氯胺酮用于小儿全麻醉既满足手术需要,又减少各自用药量,降低并发症发生率,使患儿麻醉苏醒时间明显缩短,麻醉更平稳。

OBJECTIVE To investigate the clinical efficacy of remifentanil combined with ketamine for general anaesthesia in children.METHODS 80 children with ASAⅠ-Ⅱ were randomly divided into two groups with 40 patients each.In two group,midazolam 0.02mg·kg-1 and ketamine 2mg·kg-1 was intravenously admininstered.The patients in group A received ketamine 95μg/（kg·min） by continuous infusion,and in group B,received remifentanil 0.06μg/（kg·min） combined with ketamine 58μg/（kg·min） by continuous infusion.Bliood pressure,heart rate,percutaneous Oxygen Saturation（SPO2）were monitored during operation.Meanwhile,postoperative recovery time were recorded.RESULTS Bp,SPO2 was kept well in two groups,but compared with those in group B,HR were decreased significantly in group A.before the operation（P0.05）.In group B,postoperation recovery time increased significantly in group A（P0.05）and ketamine requirement decreased in group A.CONCLUSION Remifentanil combined with ketamine could be used in children general anaesthesina with safety and effectiveness,and with the advantages of reducing drug requirement and its side effects.