氯胺酮复合丙泊酚和芬太尼用于小儿心导管术麻醉的前瞻性随机研究  

A prospective randomized comparative study of ketamine propofol vs ketamine fentanyl combinations for anesthesia in pediatric patients undergoing cardiac catheterization

作　　者：汪涛[1] 周业庭[1] 陈树秀[1] 张奎[1] 王志春[1] 迟迪[1] 

机构地区：[1]沭阳县人民医院麻醉科,江苏省223600

出　　处：《中国心血管病研究》2014年第1期86-89,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 评价静脉氯胺酮复合丙泊酚和芬太尼用于右向左分流心脏病患儿心导管介入手术麻醉的安全性和有效性.方法 50例右向左分流心脏病患儿施行心导管术,随机分为两组（25例）：氯胺酮＋丙泊酚和氯胺酮＋芬太尼组.观察和记录术中血流动力学、氧合和术后恢复各项指标及副作用.结果 两组患儿年龄、性别和麻醉时间差异无统计学意义.氯胺酮＋丙泊酚组平均动脉压、体循环血管阻力和肺/体循环血管阻力比值明显降低,而氯胺酮＋芬太尼组麻醉后动脉血氧饱和度和血氧分压明显高于氯胺酮＋丙泊酚组;术后完全恢复时间,氯胺酮＋芬太尼组明显长于氯胺酮＋丙泊酚组.结论 氯胺酮复合芬太尼用于右向左分流心脏病患儿施行心导管术的麻醉,相比氯胺酮复合丙泊酚麻醉更为安全、有效.Objective To assess and compare the safety and efficacy of continuous IV administration of a combination of ketamine propcfol versus ketamine fentanyl for anesthesia in children undergoing cardiac catheteriza- tion procedures with right to left shunt. Methods Fifty children with right to left shunt scheduled for cardiac catheterization were randomly divided into two groups of 25 patients： ketamine＋propofol （KP） and ketamine＋fen- tanyl（KF）. Hemodynamic, oxygenation, recovery variables and side effects were recorded. Results There were no statistical significant differences with age, sex, duration of anesthesia. Compared with group KP, mean arterial blood pressure （MAP）, systemic vascular resistance （SVR）, pulmonary to systemic vascular resistance ratio were significantly decreased in KP group. Additionally, SaO2 and PaO2 after anesthesia in KF group were statistically significant higher than the other group. Also there was significant prolongation of time to full recovery in KF group compared with KP group. Conclusion Combination of ketamine plus fentanyl is safer and more efficacious than ketamine plus propofol for pediatric cardiac catheterization.

关 键 词：小儿麻醉 心导管术 氯胺酮 丙泊酚 芬太尼 

分 类 号：R614[医药卫生—麻醉学]