氯胺酮复合丙泊酚麻醉在痉挛性脑瘫患儿神经干细胞移植术中的应用  

Ketamine combined with propofol in total intravenous anesthesia for spastic cerebral palsy children undergoing neural stem cell transplantation

作　　者：刘晓梅[1] 陈惠荣[1] 胡涛 

机构地区：[1]海军总医院麻醉科,北京100048 [2]河北省文安县中医院麻醉科,文安065800

出　　处：《第二军医大学学报》2012年第8期918-920,共3页Academic Journal of Second Military Medical University

摘　　要：目的评价氯胺酮复合丙泊酚静脉麻醉用于痉挛性脑瘫患儿神经干细胞移植术中的安全性。方法随机选择60例拟行神经干细胞移植术的痉挛性脑瘫患儿,ASAⅠ～Ⅱ级,给予氯胺酮+丙泊酚全静脉麻醉。麻醉诱导:丙泊酚1.5～2 mg/kg+氯胺酮1～2 mg/kg缓慢静推;麻醉维持:丙泊酚以30～40μg.kg-1.min-1、氯胺酮以10～30μg.kg-1.min-1静脉微量泵入维持镇静镇痛。术中观察平均动脉压(MAP)、心率(HR)、呼吸频率(RR),血氧饱和度(SpO2)变化,记录患儿神志消失时间、清醒时间、麻醉效果及不良反应等。结果注药后至清醒各时间点患儿MAP、HR与注药前比较无明显变化。注药后1、3 min时患儿RR减慢,SpO2下降,但与注药前比较差异无统计学意义。患儿神志消失时间为(50.5±9.1)s,清醒时间为(15.3±3.6)min。所有患儿麻醉效果均较满意,无肢体扭动、恶心呕吐、流涎等不良反应;呼吸抑制3例,呛咳1例。结论氯胺酮复合丙泊酚静脉麻醉应用于痉挛性脑瘫患儿神经干细胞移植手术可控性强,不良反应小,安全有效。Objective To evaluate the safety of ketamine combined with propofol in total intravenous anesthesia for spastic cerebral palsy children undergoing neural stem cell transplantation.Methods Sixty ASA Ⅰ-Ⅱ spastic cerebral palsy children,aged 1-12 years old,were to undergo neural stem cell transplantation.Anesthesia was induced with propofol 1.5-2 mg/kg and ketamine 1-2 mg/kg,iv,and maintained with target controlled infusion（TCI） of propofol 30-40 μg.kg-1.min-1 and ketamine 10-30 μg.kg-1.min-1.The mean arterial pressure（MAP）,heart rate（HR）,respiration rate（RR）,and arterial oxygen saturation（SpO2） were observed during operation.The consciousness loss time,awakening time,anesthetic effect,and adverse reaction were recorded.Results There were no significant differences in MAP or HR before and after infusion.The patients had decreased RR and SpO2 at 1 min and 3 min after infusion,but there is no significant difference compared with before infusion.Consciousness loss time was（50.5 ± 9.1） s and the awakening time was（15.3 ± 3.6） min.The effect of anesthesia was satisfactory in all the children.There was no writhing,nausea,vomiting or salivating.Three cases had respiratory inhibition and one had choke cough during operation.Conclusion Ketamine combines with propofol is safe,controllable and has less side effects in total intravenous anesthesia for spastic cerebral palsy children undergoing neural stem cell transplantation.

关 键 词：氯胺酮 丙泊酚 脑性瘫痪 干细胞移植 

分 类 号：R726.511[医药卫生—儿科]