小剂量氯胺酮复合丙泊酚全麻下剖宫产术的麻醉效果观察  

Effects of small dose ketamine combined with propofol in cesarean section under general anesthesia

作　　者：段中茂[1,2] 钱晓敏[1,2] 杨小磊[1,2] 

机构地区：[1]苏州大学附属常熟医院 [2]常熟市第一人民医院麻醉科,江苏省苏州市215500

出　　处：《临床合理用药杂志》2015年第31期5-6,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察小剂量氯胺酮复合丙泊酚全麻下剖宫产术对产妇生命体征和新生儿Apgar评分的影响。方法对13例实施全身麻醉的剖宫产产妇,以氯胺酮0.5mg/kg、丙泊酚1mg/kg、司可林1.5mg/kg全麻诱导,新生儿取出后,给予产妇静脉注射芬太尼0.2mg和苯磺顺阿曲库铵0.1mg/kg,并静脉持续泵入丙泊酚维持麻醉。监测和观察麻醉前后、术中术后产妇的血压(BP)、心率(HR)、血氧饱和度(Sp O2)等生命体征及新生儿取出1、5min的Apgar评分;观察术后镇痛效果、恶心呕吐、皮肤瘙痒等并发症发生率。结果 13例剖宫产术全麻诱导插管顺利,麻醉平稳,术中生命体征BP、HR、Sp O2稳定;新生儿1min Apgar评分有1例为6分,其余均≥8分,5min Apgar评分均≥9分。结论小剂量氯胺酮复合丙泊酚用于剖宫产全麻,是母婴安全、有效的麻醉方法,在不宜椎管内麻醉的剖宫产术中值得应用推广。Objective To observe the safety and effectiveness of small dose ketamine and propofol used in cesarean section. Methods 13 pregnant women were performed cesarean section under general anesthesia induced by 0. 5mg / kg ketamine,1mg / kg propofol,1. 5mg / kg scoline. After the removal of newborn,the parturients receieved intravenous 0. 2mg fentanyl and 0. 1mg / kg cisatracurium besilate,and propofol continuous infusion. The BP,HR,Sp O2 of parturients and Apgar score of1 min,5min after birth,the analgesic effect and complications such as nausea and vomiting,itching were recorded during anesthesia were monitored and observed. Results All patients passed through the induction and maintenance of anesthesia smoothly. The vital signs of parturients were stable during operation. For Apgar score 1min after birth,one newborn was 6 with the rest above 8. 5min after birth,the Apgar score of all newborn was found to be more than 9. Conclusion Small dose ketamine and propofol are safe and effective in cesarean section for maternal and infant,especially for those unsuitable for intravertebral anesthesia.

关 键 词：氯胺酮 丙泊酚 剖宫产 全麻 

分 类 号：R614[医药卫生—麻醉学]