瑞氯合剂复合丙泊酚在小儿非插管全麻中的应用

目的探讨瑞芬太尼和氯胺酮复合丙泊酚用于小儿非插管全麻的临床效果。方法将100例ASAⅠ～Ⅱ级患儿随机分为A、B两组,每组各50例。A组采用常规的方法氯胺酮+咪唑安定,B组氯胺酮和瑞芬太尼及丙泊酚。术中严密监测患儿血压、心率,及SpO2和BIS,并记录氯胺酮的用量和术后苏醒时间。结果 A、B两组患儿血压和SpO2均较平稳,但B组心率较术前明显减慢(p<0.05),而A组心率较术前明显增快(p<0.05),B组术后麻醉苏醒明显快于A组(p<0.05),且术中氯胺酮用量明显少于A组(p<0.05)。结论瑞芬太尼和氯胺酮复合丙泊酚用于小儿全麻既满足手术需要,又减少各自用药量,降低并发症发生率,使患儿麻醉苏醒时间明显缩短,麻醉更平稳。

CLINICAL OBSERVATION OF REMIFENTANIL COMBINED WITH KETAMINE AND PROPOFOL IN PEDIATRIC GENERAL ANESTHESIA

Objective To investigate the clinical efficacy of remifentanil combined with ketamine and prpofol for general anaesthesia in children. Methods 100 children with ASAⅠ-Ⅱ were randomly divided into two groups A and B,with 50 patients each.In the usual way,the patients in group A received ketamine by continuous infusion and midazolam,in group B,received remifentanil combined with ketamine and propofol by continuous infusion.Blood pressure,heart rate,percutaneous Oxygen Saturation（SpO2） and BIS were monitored during operation.Meanwhile,postoperative ketamine requirement and recovery time were recorded. Results BP,SpO2 was kept well in two groups,but compared than before operation,HR were increased significantly in group A（p0.05）;and decreased significantly in group B（p0.05）. In group B,postoperation recovery time decreased significantly than in group A（p0.05） and ketamine requirement decreased in group B. Conclusion Remifentanil combined with ketamine and propofol could be used in children general anaesthesina with safety and effectiveness,and with the advantages of reducing drug requirement and its side effects.