小儿脑室分流术静脉复合麻醉用药效果的比较

Comparison of Efficacies of Intravenous Anesthesia for Pediatric Cerebral Ventricular Shunt ketamine combined with sodium hydroxybutyrate and propofol respectively

目的 比较氟芬合剂、羟丁酸钠、异丙酚分别联合氯胺酮在小儿脑室分流术麻醉中的效果。方法 4 5例ASAⅠ～Ⅱ级的患儿随机分为 3组 ,氟芬合剂组 (A组 )、羟丁酸钠组 (B组 )和异丙酚组 (C组 ) ,3组均复合氯胺酮。观察术中麻醉效果和循环呼吸相关指标及麻醉恢复期睁眼和清醒时间。结果 3组麻醉有效率10 0 % ,显效率 :A组 93%、B组 86 7%、C组 10 0 % ;心率和收缩压 :B组高于A、C两组 (P <0 0 5 ) ;3组呼吸频率无明显差异 (P >0 0 5 ) ;血氧饱和度 :A组在诱导后 5～ 10min内出现极显著差异 (P <0 0 1) ;麻醉恢复期苏醒时间 :C组明显短于A、B两组 (P <0 0 1)。结论 经比较B、C两组均能安全用于小儿脑室分流术静脉麻醉。在稳定循环和术毕清醒时间方面 。

Objective To compare efficacies of Ketamine comb in ed with sodium hydroxybutyrate and propofol respectively as anesthesia for pedia tric cerebral ventricular shunt.Method forty-six ASA Ⅰ-Ⅱ pediatric patients were randomly allocated into two groups.Sodium hydroxybutyrate group(Group A)( n =23),and propofol group(Group B)( n =23).Both of them were combined with Ketam ine. The anesthetic during operation,the relative indexes of circulation and breath,t he time of opening eyes and the time of awakening during recovery period of anes thesia were recorded separately.Result The anesthetic efficacies of two groups were 100%.The rate of efficacy:Group A 87%,Group B 100%.The systolic blood press ure:Group A was higher than Group B( P <0 05).There was no significant diffe renc e in breath rate and oxygen saturation of blood( P >0 05).The time of awaken ing during recovery period of anesthesia:Group B was significantly shorter than Grou p A( P <0 01).Conclusion Group A,B can be used safely as intravenous anesth esia for pediatric cerebral ventricular shunt with insertion of pipes not into trach eas.The efficacy of group B is superior to that of Group A in stability of circu lation and the time of awakening after operation.