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目的 在小儿整形外科手术中寻找异丙酚与氯胺酮复合静脉麻醉最佳搭配方案。方法 选择 36例外耳再造术患儿 ,随机分为四组 ,各组均用异丙酚和氯胺酮不同搭配比例维持麻醉。观察各组病人的麻醉过程中的血流动力学变化情况和麻醉恢复情况 ,同时记录异丙酚与氯胺酮的平均用量。结果 与第二、三、四组相比 ,第一组的异丙酚与氯胺酮用量多、麻醉恢复拔管时间较长、同时麻醉后出现头晕、复视等并发症发生率也较高 (P <0 0 5 )。第二、三组异丙酚用量无统计学差异 (P >0 0 5 ) ,而氯胺酮用量则有统计学差异 (P <0 0 5 )。第三组血流动力学不稳定 (P <0 0 5 )。结论 在小儿整形外科手术中选用适当搭配比例的异丙酚与氯胺酮 (手术前期用异丙酚 6mg·kg-1·h-1、氯胺酮 1 2mg·kg-1·h-1麻醉维持 ;手术中后期用异丙酚 6mg·kg-1·h-1、氯胺酮 0 8mg·kg-1·h-1维持 ;手术后期用异丙酚 6mg·kg-1·h-1维持并根据病人具体情况逐步减少异丙酚的输注速率 )复合静脉麻醉是一理想而且经济的麻醉方案。
Objective To find the optimal combination of propofol and ketamine intravenous anesthesia in pediatric plastic surgery. Methods Thirty-six cases of auricular reconstruction were randomly divided into four groups. All groups were anesthetized with propofol and ketamine in different proportions. The changes of hemodynamics and recovery of anesthesia during anesthesia were observed in each group. Meanwhile, the average dosage of propofol and ketamine was recorded. Results Compared with the second, third and fourth groups, the first group had more propofol and ketamine, longer anesthesia extubation, dizziness after anesthesia and higher complications such as diplopia (P <0 0 5). There was no significant difference in the dosage of propofol among the three groups (P> 0.05), while the dosage of ketamine was statistically different (P <0.05). The third group was hemodynamically unstable (P <0 05). Conclusions Propofol and ketamine (propofol 6 mg · kg-1 · h-1, Ketamine 12 mg · kg-1 · h-1) were appropriately maintained in pediatric plastic surgery. During operation, Propofol 6 mg · kg-1 · h-1 and ketamine 0 8 mg · kg-1 · h-1 at the later stage. After the operation, propofol was maintained at 6 mg · kg-1 · h-1 and gradually increased according to the patients’ specific conditions Reduce propofol infusion rate) Compound intravenous anesthesia is an ideal and economical anesthetic protocol.