异丙酚-氯胺酮用于夹层主动脉瘤腔内隔绝术麻醉的体会  

Intravenous anesthesia with propofol and ketamine for endovascular stent graft repair of aortic dissecting aneurysm

作　　者：曾志文[1] 柴云飞[2] 俞润英 罗沙[2] 王晟[2] 

机构地区：[1]广东省梅州市人民医院麻醉科,514031 [2]广东省医学科学院,广东省人民医院,广东省心血管病研究所麻醉科,广州市510080

出　　处：《实用医学杂志》2013年第6期950-952,共3页The Journal of Practical Medicine

基　　金：2010年广东省自然科学基金资助项目(编号:10451008002006285)

摘　　要：目的:探讨异丙酚复合氯胺酮不插管静脉全身麻醉用于夹层主动脉瘤腔内隔绝术的安全性和有效性。方法:回顾性分析DeBakeyⅢ型夹层主动脉瘤患者的临床资料,总结分析异丙酚复合氯胺酮不插管全身麻醉配合术中控制性降压技术用于夹层主动脉瘤腔内隔绝术的临床效果和经验。结果:239例患者(男214例,女25例)均获得满意的麻醉效果。呼吸抑制轻微,术中一过性呼吸抑制发生率4.6%、重度舌后坠发生率3.8%,简单处理均好转。术中血流动力学控制良好;术后苏醒迅速、无麻醉相关的并发症发生。结论:异丙酚复合氯胺酮不插管静脉全身麻醉可安全有效地用于主动脉夹层瘤动脉腔内隔绝术的麻醉处理,但应注意术中呼吸管理。Objective To evaluate the anesthetic effect and sa｜＇e.ty of intravenous anesthesia without endotracheal intubation induced by propofnl and ketamine in endovascular stent graft repair operation of aortic dissecting aneurysm. Methods A total of 239 patients with aortic aneurysm of Debakev Ⅲ type underwent endovascular stent repair under general anesthesia anti controlled hypotension. The intravemms anesthesia without endotraeheal intubation was adopted with propofol and ketamine mostly. An intravenous infusion of sodium nitruprusside was given to achieve systolic pressure between 100 and 140 mm Hg during operation, anti the systolic pressure maintained between 60 and 80 mm Hg before release of the stent. Results The respiratory system and circulatory system were steady during anesthesia in this study. There were no eases having anesthetic complications. Conclusion The intravenous anesthesia without endotracheal intubation induced by propofol anti ketmnine is safety and effectiveness for endovascular stent graft repair of aortic dissecting aneurysm.

关 键 词：主动脉瘤 腔内隔绝术 麻醉 异丙酚 氯胺酮 

分 类 号：R614[医药卫生—麻醉学]