异丙酚-氯胺酮静脉复合麻醉在乳腺区段切除术中的应用  

Effefcts of propofol - ketamine total intravenous anesthesia in the mammary gland partial excision

作　　者：李岩[1] 孟瑞霞[1] 

机构地区：[1]河南省新乡市中心医院麻醉科,新乡453000

出　　处：《中原医刊》2007年第13期3-4,共2页Central Plains Medical Journal

摘　　要：目的观察异丙酚-氯胺酮静脉复合麻醉用于乳腺区段切除术的临床效果。方法106例ASAI～Ⅱ级乳腺区段切除术患者，静脉注射咪唑安定2mg，然后靶控输注异丙酚，雏持血浆浓度3μg／m1，在术者分离乳腺组织前5min，加氯胺酮1～1．5mg／kg，手术缝合时停止泵注异丙酚。观察基础值及麻醉后、手术开始时、分离乳腺组织时、术毕时的血流动力学变化及术毕清醒时间、恶心、呕吐发生率。结果组内血流动力学：心率（HR）、收缩压（SBP）、舒张压（DBP）稳定，与术前相比差异无统计学意义（P〉0．05）；20例（17％）苏醒期间有轻微头晕，9例（8％）恶心，无呕吐。结论异丙酚-氯胺酮静脉复合应用能产生药物协同作用，且对呼吸循环功能干扰小，可保持乳腺区段切除术过程平稳安全。To observe the effects of propolol -ketamme total intravenous anesthesia （TIVA） in the mammary gland partial excision. Methods 106 ASA I - 1I patients received breast swelling operation. 2 mg midazolam was intravenous injected and, anesthesia was maintained with TCL of propofol of which the plasma concentration was set at 3 μg/ml. During the seperation of musculus mammary gland, ketamine was given 1 1,5 mg/kg intravenous injection. Stop the injection of propofol at the time of suture. Record the he- modynamic parameters （ HR, SBP, DBP） before anesthesia, after anesthesia, the beginning of operation, the time of musculus mammary gland and the end of operation, and at the time of consciousness ,the incidences of nau- sea and vomitting were observed. Results The differences of the hemodynamic parameters （HR, SBP, DBP） were insignificant（ P 〉 0.05 ） at the various recording time. 20 patients （ 18% ） had slight diziness. 9 patients （8%） had slight nausea at the time of consciousness. Conclusion Propofol - ketamine TIVA may be increase effective, the side effect and the influence on the respiratory. Their circulative function are little. They Can maintain the stability and safety in the mammary gland partial excision.

关 键 词：异丙酚 氯胺酮 静脉复合麻醉 乳腺区段切除术 

分 类 号：R647[医药卫生—外科学]