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目的评价氯胺酮复合异丙酚麻醉应用于经皮小儿先天性心脏病介入治疗的安全性和可行性。方法 85例拟行先天性心脏病介入治疗的患儿随机分为氯胺酮组(K组,n=44)和氯胺酮复合异丙酚组(KP组,n=41)。K组:静脉注射氯胺酮1mg.kg-1后以50μg.kg-1.min-1输注维持。KP组:静脉注射氯胺酮1mg·kg-1+异丙酚1mg·kg-1,之后氯胺酮16.7μg.kg-1.min-1+异丙酚33.3μg.kg-1.min-1输注。连续监测心电图、血压、脉搏、呼吸频率、血氧饱和度,并记录苏醒时间。结果二组患儿血流动力学及呼吸功能稳定。K组氯胺酮用量[(52.1±2.8)μg.kg-1.min-1]显著高于KP组[(25.3±7.3)μg.kg-1.min-1],KP组睁眼时间和完全清醒时间分别为(9.8±5.7)min和(40.4±18.3)min,K组睁眼时间和完全清醒时间分别为(11.2±1.0)min和(50.2±16.5)min。二者比较,差异有统计学意义。结论氯胺酮复合异丙酚用于经皮小儿先天性心脏病介入封堵麻醉安全、平稳,患儿苏醒快。
Objective To evaluate the safety and feasibility of ketamine combined with propofol anesthesia in percutaneous pediatric congenital heart disease interventional therapy. Methods Totally 85 children with congenital heart disease undergoing interventional therapy were randomly divided into ketamine group (K group, n = 44) and ketamine combined propofol group (KP group, n = 41). K group: intravenous injection of ketamine 1mg.kg-1 to 50μg.kg-1.min-1 infusion to maintain. KP group: Ketamine 1 mg · kg -1 + propofol 1 mg · kg -1 was injected intravenously, followed by ketamine 16.7 μg.kg -1 · min -1 + propofol 33.3 μg.kg -1 · min -1. Continuous monitoring of ECG, blood pressure, pulse, respiratory rate, oxygen saturation, and record the recovery time. Results The hemodynamics and respiratory function of the two groups were stable. Ketamine dosage in group K [(52.1 ± 2.8) μg.kg-1.min-1] was significantly higher than that in KP group [(25.3 ± 7.3) μg.kg-1.min-1] (9.8 ± 5.7) min and (40.4 ± 18.3) min, respectively. The open eye time and complete awake time in group K were (11.2 ± 1.0) min and (50.2 ± 16.5) min, respectively. The two were compared, the difference was statistically significant. Conclusions Ketamine propofol is safe and stable for percutaneous pediatric congenital heart disease with interventional anesthesia.