亚麻醉剂量氯胺酮复合丙泊酚在小儿无痛纤支镜检查术中的应用  

Application of Sub-anesthetic Dose of Ketamine Combined with Propofol in Pediatric Painless Fiberoptic Bronchoscopy

作　　者：王瑞珂[1] 李春玲[1] 钟涛[1] 张丽娜[1] 孙蓓[1] 郭曲练[1] 

机构地区：[1]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《医学临床研究》2011年第5期903-905,共3页Journal of Clinical Research

摘　　要：【目的】研究亚麻醉剂量氯胺酮复合丙泊酚在小儿无痛纤维支气管镜（纤支镜）检查术中的应用。【方法】拟行无痛纤支镜检术患儿60例，按随机数字表法分为3组：I组患者予丙泊酚2mg／kg缓慢静脉注射；Ⅱ组先予静脉注射芬太尼1ug／kg，5rain后缓慢静脉注射丙泊酚2mg／kg，III组先予氯胺酮0．5mg／kg，5min后缓慢静脉注射丙泊酚2mg／kg。观察3组患者在麻醉前（T。）、操作前（T。）、操作时（T：）以及术毕（T。）的心率（HR）、血压（MAP）、血氧饱和度（SpO：）、呼吸频率（RR）以及丙泊酚用药剂量、睁眼时间及不良反应的发生情况。【结果】I组，Ⅱ组HR，MAP，RR，SpO：于T。时间点均较T。明显下降（P〈O．05），Ⅲ组各参数于T1，T2，T。各时间点与T。比较差异均无显著性（P〉0．05）。II组，Ⅲ组丙泊酚用药量较I组明显减少（P〈O．05），Ⅱ组呼吸抑制发生率明显高于Ⅲ组，且差异有显著性（P〈O．05）。【结论】亚麻醉剂量氯胺酮复合丙泊酚静脉麻醉应用于小儿纤支镜检查术，麻醉效果满意且不良反应较少，是一种安全有效的配伍用药方式。[Objective] To investigate the application of sub-anesthetic dose of ketamine combined with propofol in pediatric painless fiberoptic bronchoscopy（FB）. [Methods] Sixty children scheduled for FB were divided into three groups. Group ~ was injected intravenously with propofol 2mg/kg. Group Ⅱ was injected intravenously with fentanyl 1 μg/kg and then with propofol 2mg/kg slowly 5min later. Group Ⅲ was given ketamine 0.5mg/kg, and then with propofol 2mg/kg slowly 5min later. Mean arterial pressure（MAP）, heart rate （HR）, respiration rate（RR） and pulse oxygen saturation（SpO2 ） were recorded before anesthesia（T0 ）, before operation（T1 ）, during operation（T2 ） and after operation（T3 ）. Propofol dose, the wake-up time and adverse reaction were observed, tResults] Compared with T0, the HR, MAP, RR and SpO2 in Group I and Ⅱ decreased significantly at T1 （ P 〈0.05）. Compared with To, there was no significant difference in the a- bove parameters in Group Ⅲ among T1 , T2 and T3 （ P 〉0.05）. The consumption of propofol in Group Ⅱ and Group Ⅱ was lower than that in Group I （ P 〈0. 05）. The rate of respiratory inhibition in Group Ⅱ was higher than that in Group Ⅱ , and there was significant difference（ P 〈0.05）. [Conclusion] Sub-anesthetic dose of ketamine combined with propofol for pediatric painless fiberoptic bronchoscopy has satisfactory effect and few side reactions, so it is a safe and effective combination medication method.

关 键 词：支气管镜检查 氯胺酮/投药和剂量 酚类/投药和剂量 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]