观察小剂量氯胺酮与中剂量戊巴比妥对幼猪心内直视手术的复合麻醉效果  

Observation of combination anesthesia with low-dose ketamine and mid-dose pentobarbital for open heart surgeryin juvenile pigs

作　　者：柳德斌 邵燕斌[3] 栾秀姝 税朝祥 张振亚 吴清玉 

机构地区：[1]清华大学第一附属医院心脏中心,北京100016 [2]兰州大学第一医院心外科 [3]清华大学第一附属医院麻醉科,北京100016 [4]清华大学第一附属医院临床实验中心,北京100016

出　　处：《中国临床药理学杂志》2010年第1期49-52,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(30772152)

摘　　要：目的观察小剂量氯胺酮（静脉麻醉药）与中剂量戊巴比妥（镇静、催眠药）对幼猪心内直视手术的复合麻醉效果。方法幼猪30例，肌注氯胺酮3mg·kg^-1和戊巴比妥20mg·kg^-1诱导插管；分别静注氯胺酮、戊巴比妥钠、咪达唑仑、哌库溴铵5，6～8，0．1～0．2，0．1mg·kg^-1·h^-1，维持麻醉，转机后停用戊巴比妥；记录各期生命体征、血流动力学和动脉血气分析参数等指标的变化。结果30例于各期血流动力学稳定，麻醉诱导和麻醉维持时间分别为（9±2），（179±15）min；2例分别在诱导期和拔管后，出现呼吸心跳骤停，均抢救成功；诱导和维持效果达Ⅰ级者分别占73．3％和80．0％。结论小剂量氯胺酮和中剂量戊巴比妥有利于改善呼吸和循环抑制，联合用药兼备镇静和镇痛效果，可达到很好地外科麻醉效果。Objective To investigate combination anesthesia with lowdose ketamine and mid- dose pentobarbital for open heart surgery in juvenile pigs. Methods Thirty experimental juvenile pigs received ketamine （3 mg · kg^-1 ） and pentobarbital （20 mg · kg^-1） intramuscularly for induction and intubation, then were given ketamine （5 mg· kg^-1· h^-1）, pentobarbital （6- 8 mg · kg^-1· h^-1）, midazolam （0. 1 -0.2 mg· kg^-1· h^-1 ） and pipecuronium （0. 1 mg · kg^-1· h^-1 ） intravenously for maintenance. The infusion of pentobarbital was withdrawn after cardiopulmonary bypass started. During the experimental treatment, vital signs were monitored; artery gas analysis and hemodynamic parameters were recorded. Results Twenty - eight juvenile pigs got stable hemodynamic parameters in the perioperative period. The time of anesthetic induction and maintenance is （9 ± 2） and （179± 15） min, respectively. The respiratory and cardiac arrest rates were 6.7% in induction and 3.3 % in maintenance, respectively. Two cases got respiratory and cardiac arrest, on in induction and the other after extubation. In addition, class Ⅰ anesthetic effectiveness was achieved 73.3% in induction and 80. 0% in maintenance, respectively. Conclusion This study demonstrated that low - dose ketamine combined with mid - dose pentobarbital has little inhibition on respiration and circulation. The combination can achieve both hypnosis and analgesia effects with good surgical anesthetic effectiveness in juvenile pigs with open heart surgery.

关 键 词：复合麻醉 心内直视手术 氯胺酮 

分 类 号：R965.1[医药卫生—药理学] R971.2[医药卫生—药学]