论文部分内容阅读
理想的小儿静脉复合麻醉需要镇痛完善,无呼吸抑制,苏醒快而完全,术后无不良反应。由于氯胺酮的消除半衰期长,可以明显延长苏醒时间,且剂量过大可导致术后一系列不良反应。本文通过异丙酚复合氯胺酮静注与单独应用氯胺酮静注的比较探讨复合用药具有的优越性。1 临床资料1.1 一般资料:本组22例,男19例,女3例,均为骨科,泌尿科、普外科及五官科患儿,年龄2～8岁,ASAⅠ级,随机分为两组,A组异丙酚氯胺酮组,B组氯胺酮组,两组在年龄、体重,手术时间上无统计学差异,具有可比性。1.2 观察比较指标:(1)氯胺酮用量;(2)麻醉苏醒评价(分两阶段即肢体活动出现时间和出现应答反应时间);(3)术后无不良反应。1.3 麻醉方法:术前半小时肌注鲁米那钠2mg/kg,阿托品0.01～0.02mg/kg。入室后,两组肌注氯胺酮4mg/kg。A组1％异丙酚4～6mg/kg/h静脉滴注,术中根据情况间断静注氯胺酮1～2mg/kg,B组术中静脉间断推注氯胺酮1～2mg/kg。麻醉过程中两组病人均连续监测氧饱和度(SPO_2)、呼吸(R)、心率(HR)。保持呼吸道通畅,鼻导管或面罩吸纯氧。
Ideal pediatric intravenous anesthesia need analgesia perfect, no respiratory depression, wake up quickly and completely, no adverse reactions after surgery. As the elimination of ketamine long half-life, can significantly extend the recovery time, and excessive doses can lead to a series of adverse reactions. In this paper, the propofol combination ketamine intravenous ketamine ketamine intravenous compared to explore the advantages of the combination of drugs. 1 Clinical data 1.1 General Information: The group of 22 patients, 19 males and 3 females, all orthopedics, urology, general surgery and ENT children, aged 2 to 8 years old, ASA Ⅰ level, were randomly divided into two groups, A group of propofol ketamine group, ketamine group B, two groups in age, weight, duration of surgery was no significant difference, comparable. 1.2 Observation and comparison of indicators: (1) ketamine dosage; (2) assessment of anesthesia awakening (two phases of limb activity occurs and response time); (3) no postoperative adverse reactions. 1.3 Anesthesia method: half an hour before surgery muscle luminal sodium 2mg / kg, atropine 0.01 ~ 0.02mg / kg. Into the room, two groups of ketamine ketamine 4mg / kg. Group A 1% propofol 4 ~ 6mg / kg / h intravenous infusion of intraoperative intermittent intravenous ketamine 1 ~ 2mg / kg, intraoperative intravenous bolus injection of ketamine 1 ~ 2mg / kg. During anesthesia, two groups of patients were continuously monitored for oxygen saturation (SPO_2), respiration (R) and heart rate (HR). Keep the airway open, nasal cannula or mask inhale pure oxygen.