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

    • 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=15):A组微泵输注丙泊酚1.5 mg/kg,继之微泵输注丙泊酚1 mg·kg-1·h-1镇静;B组微泵输注丙泊酚1.5 mg/kg,继之微泵输注丙泊酚1 mg·kg-1·h-1氯胺酮0.5 mg·kg-1·h-1镇静。两组患儿均于静脉注药5 min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<0.01),苏醒期BIS低于B组(P<0.05),苏醒时间和丙泊酚的用量A组均显著多于B组(P<0.01)。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,丙泊酚合用小剂量氯胺酮优于单独使用。

       

      Abstract: 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.

       

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