异丙酚或羟丁酸钠合用氯胺酮用于脑室分流术麻醉的比较

Comparison of ketamine combind with propofol or sodium hydroxybutyrate as anesthesia for cerebral ventricular shunt

目的:比较异丙酚合用氯胺酮与羟丁酸钠合用氯胺酮在脑室分流术麻醉中的效果。方法:34例患者ASA分级为Ⅰ～Ⅱ级,随机分为两组,异丙酚组和羟丁酸钠组各17例。分别静脉注射异丙酚2mg/(kg·h)(用微泵维持)和羟丁酸钠50mg/kg。两组均给予静脉注射氯胺酮1mg/kg。观察术中的心率、收缩压、呼吸率和血氧饱和度以及麻醉恢复期的睁眼和清醒时间。结果:两组在10分钟以后收缩压、心率出现差异,经t检验,P<0.05;在呼吸率、血氧饱和度方面无统计学意义;在术毕睁眼和清醒方面有极显著差异(P<0.01)。结论:经比较,两组静脉复合麻醉的临床效果均满意。在稳定循环、术毕睁眼和清醒方面,异丙酚组优于羟丁酸钠组。

Objective: To compare efficacies of ketamine combined with propofol or sodium hydroxybutyrate as anesthesia for cerebral ventricular shunt. Method:Thirty-four ASA Ⅰ - Ⅱ patients were radomly allocated into two groups, with 17 cases in each group. Ketamine 1 mg/kg together with propofol 2 mg/(kg · h) (Group A)or sodium hydroxybutyrate 50 mg/kg(Group B) were given as intravenous anesthesia. Changes of heart rate, systolic blood pressure, breath rate, oxygen saturation of blood during operation and the time of opening eyes and the time of awakenking during recovery period of anesthesia were recorded separately. Result:The differences in changes of systolic blood pressure and heart rate at 10 min after iv drug between two groups were significant (P<0. 05). There were no significant difference in breath rate and oxygen saturation of blood. The time of opening eyes and the time of awakening in Group A were very significantly shorter than in Group B(P<0. 01). Conclusion;The clinical efficacies of anesthesia in both two groups were satisfactory. The efficacy of groupA is superior to that of Group B in stability of circulation, the time of opening eyes and the time of awakening after operation.