丙泊酚合用小剂量氯胺酮对幼儿骶管阻滞的影响  

Use of propofol-low dose ketamine in sacral anesthesia in infants

作　　者：高敏[1] 

机构地区：[1]上海第二医科大学附属瑞金医院卢湾分院麻醉科,200020

出　　处：《蚌埠医学院学报》2004年第1期36-37,共2页Journal of Bengbu Medical College

摘　　要：目的 :研究幼儿行骶管阻滞时 ,丙泊酚合用小剂量氯胺酮对幼儿循环呼吸与脑电双频指数 (BIS)的影响。方法 :将30例行骶管阻滞的 3岁幼儿随机分为两组 (n =1 5 ) :A组微泵输注丙泊酚 1 .5mg/kg ,继之微泵输注丙泊酚 1mg·kg-1 ·h-1 镇静 ;B组微泵输注丙泊酚 1 .5mg/kg ,继之微泵输注丙泊酚 1mg·kg-1 ·h-1 氯胺酮 0 .5mg·kg-1 ·h-1 镇静。两组患儿均于静脉注药 5min后行骶管内麻醉 ,丙泊酚的速率根据术中BIS要求变速持续输注。结果 :术中A组的心率、平均动脉压明显低于术前 (P <0 .0 1 ) ,苏醒期BIS低于B组 (P <0 .0 5 ) ,苏醒时间和丙泊酚的用量A组均显著多于B组 (P <0 .0 1 )。结论 :在幼儿骶管内麻醉 ,丙泊酚合用小剂量氯胺酮血液动力学稳定 ,对呼吸影响小 ,苏醒时间短 ,丙泊酚用量少。作为镇静辅助用药 。Objective:To evaluate the influence of propoflo low dose ketamine in sacral anesthesia in infants on circula,respiratory and bispectral index(BIS).Methods:Thirty infants were randomly divided into two groups(15 cases in each):group A were injected propofol 1.5 mg/kg and maintenanced by continuous propofol 1 mg·kg -1 ·h -1 infusion;group B were injected propofol 1.5 mg/kg,sedation was maintenanced by continuous propofol 1 mg·kg -1 ·h -1 and ketamine 0.5 mg·kg -1 ·h -1 infusion.Sacral anaesthesia was given five minutes after injecting propofol.Rating of propofol infusion was adjusted to BIS in the operation.Results:In group A,HR and MAP during operation were much lower than those before operation( P <0.01).BIS of emergence in group A was lower than that in group B( P <0.05),The emergence time and the dose of propofol during maintenance in group A were much higher than those in group B( P <0.01).Conclusions:Propofol low dose ketamine has the advantages of hemodynamic stability,lower dose of propofol and rapider emergence as compared with using propofol alone in sacral anaesthesia in infants.

关 键 词：麻醉 骶管内 丙泊酚 氯胺酮 镇静 

分 类 号：R614.42[医药卫生—麻醉学]