依托咪酯脂肪乳与氯胺酮静脉复合麻醉在小儿短小手术中的应用

Application of Intravenous Anesthesia of Etomidate Fat Emulsion Combined with Ketamine in Children Minor Surgery

[目的]探讨依托咪酯脂肪乳与氯胺酮静脉复合麻醉在小儿短小手术中的可行性和安全性.[方法]对使用了依托咪酯脂肪乳与氯胺酮静脉复合麻醉于儿科短小手术的1 195例患儿的临床资料进行回顾性分析.对患儿术前一般情况,术中麻醉药物使用总量,手术时间,苏醒时间,术中不同时间点心率、血压的变化,术后并发症发生率进行统计分析.[结果]所有手术均顺利完成,术中心率不同时间点间两两对比有统计学差异（P＜0.05）,术中血压不同时间点间两两对比有统计学差异（P＜0.05）,不良反应中,呼吸抑制发生率20.7%,喉痉挛发生率1%,局部注射痛发生率1.5%,肌阵挛发生率2.7%,恶心、呕吐发生率7.1%,苏醒期躁动发生率5.4%.[结论]依托咪酯脂肪乳复合氯胺酮静脉麻醉可安全应用于小儿短小手术.

[Objective] To explore the feasibility and safety of intravenous anesthesia of etomidate fat emulsion combined with ketamine for children minor surgery. [Methods] Clinical data of 1195 children who underwent minor surgery under intravenous anesthesia of etomidate fat emulsion combined with ketamine from September 2003 to June 2010 were analyzed retrospectively. Preoperative general condition, the total dosage of intraoperative anesthesia, operation time, awakening time, the changes of heart rate and blood pressure at dif ferent time during the operation and the incidence of postoperative complications were analyzed by statistics. [Results]All operations were completed successfully. There was significant difference in the intraoperative heart rate between any of the two different time（ P d0.05）. There was also significant difference in the blood pressure between any of the two different time（ P d0.05）. The incidence of respiratory depression, laryngospasm, local injection pain, myoclonus, nausea and vomiting, agitation at the stage of analepsia was 20.7 %, 1%, 1.5%, 2.7%, 7.1% and 5.4%, respectively. [Conclusion] Intravenous anesthesia of etomidate fat emulsion combined with ketamine can be used safely in minor surgery of children.