氯胺酮复合异丙酚或γ-羟丁酸钠用于小儿静脉麻醉的对比研究

A CONTRAST RESEACH ON JOINT ADMINISTRATION OF KETAMINE WITH PROPOFOL AND WITH γ-OH IN GENERAL ANESTHESIA FOR INFANT

目的 :探讨氯胺酮与异丙酚 (Propofol)复合应用对小儿呼吸循环功能的影响程度 ,为临床麻醉的改进提供理论依据。方法 :选择 40例ASA -Ⅰ级小儿短时间手术 ,随机分为氯胺酮 -异丙酚组 (P组 ,n =2 0 )和氯胺酮 -γ-羟丁酸钠组 (γ组 ,n =2 0 )。术前用药均为阿托品 0 0 1mg kg ,安定 0 2mg kg ,术前 30min肌注。麻醉开始静注氯胺酮复合异丙酚 (P组 )或γ -羟丁酸钠 (γ组 )诱导 ,术中微泵输注异丙酚复合间断静注氯胺酮 (P组 )或单独静注氯胺酮 (γ组 )维持麻醉。结果 :P组平均苏醒时明显低于γ组 (P <0 0 1) ;手术开始切皮时血压升高P组明显低于γ组 (P <0 0 5 )。两组间间接血氧饱合度 (SpO2 )无差异。结论 :异丙酚 -氯胺酮用于小儿短时间手术全凭静脉麻醉 (TIVA)时 ,两药可有协同催眠与麻醉效应。

OBJECTIVE:To determine effect of joint administration of ketamine and propofol as general anesthetic on respiratory and circulation function in infant patients and provide experience for clinical anesthesia. METHOD:40 infant patients with grade one on ASA physical status were divided into two groups at random administering Ketamine plus propofol (Experimental group) and Ketamine plus γ-OH (control group) respectively. All patients were administered atropine and diazepam preoperatively. In experimental group, anesthesia was induced by ketamine and propofol with maintenence of miro-pump injection of propofol and discontinuous injection of ketamine. In control group, anesthesia was induced by γ-OH and maintained by intravenous injection of ketamine.RESULTS:Waking time in experimental group was remarkably shorter than that in control group (P<0 01). Blood pressure increase at the beginning was not obvious in experimental group (P<0 05).CONCLUSION:Joint administration of propofol and ketamine has synergistic action on general intravenous anesthesia for the infant. Ketamine can abate the inhibiting effect of propofol on cardiovascular system.