论文部分内容阅读
目的:观察小剂量氯胺酮在新生儿全麻诱导中的效果及其不良反应。方法:60例需全麻的新生儿患者随机均分为七氟醚组(S组)和七氟醚联合氯胺酮组(SK组),S组单用七氟醚吸入麻醉诱导,SK组采用七氟醚吸入,同时静脉给予氯胺酮0.5 mg·kg~(-1)联合诱导。观察并记录患儿入室时(T0),气管插管前即刻(T1),插管后1 min(T2),切皮时(T3),停药时(T4)及拔除气管即刻(T5)时的平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO_2)、呼气末CO_2分压(PetCO_2)。记录两组患儿从吸入诱导到插管时七氟醚的用量,一次气管插管成功率,喉痉挛、苏醒延迟、苏醒期躁动发生率。结果:S组T_1与T_0的MAP值比较差异有统计学意义(P<0.05)。两组T_1的MAP值比较差异有统计学意义(P<0.05)。两组患儿七氟醚的用量、一次插管成功率、喉痉挛发生率相比较,差异有统计学意义(P<0.05)。结论:小剂量氯胺酮复合七氟醚在新生儿全麻联合诱导可以有效提高气管插管的成功率,减少插管时并发症的发生,减少七氟醚的用量。
Objective: To observe the effects and adverse reactions of low-dose ketamine in induction of neonatal general anesthesia. Methods: Sixty neonates with general anesthesia were randomly divided into sevoflurane group (S group) and sevoflurane plus ketamine group (SK group). S group was induced by sevoflurane inhalation anesthesia alone and SK group Fluoride inhalation, while intravenous ketamine 0.5 mg · kg ~ (-1) combined induction. The T0, T immediately before tracheal intubation, 1 min after intubation, T2, T3, T4 and T5 were observed and recorded. (MAP), heart rate (HR), oxygen saturation (SPO_2) and end - tidal CO_2 partial pressure (PetCO_2). The amount of sevoflurane, the success rate of primary tracheal intubation, laryngospasm, delayed wakefulness and the rate of restlessness during recovery were recorded in two groups from inhalation to intubation. Results: There was significant difference in MAP value between T 1 and T 0 in group S (P <0.05). There was significant difference of T_1 MAP between the two groups (P <0.05). The two groups of children with sevoflurane dosage, a success rate of intubation, laryngeal spasm incidence compared to the difference was statistically significant (P <0.05). CONCLUSION: Combined administration of low-dose ketamine and sevoflurane in neonatal general anesthesia can effectively improve the success rate of tracheal intubation, reduce the incidence of complications during intubation and reduce the dosage of sevoflurane.