小剂量氯胺酮用于剖宫产手术的临床观察

目的 研究小剂量氯胺酮用于剖宫产手术的临床效果及安全性.方法 将60例择期ASAⅠ～Ⅱ级、单胎、足月妊娠,拟在持续硬膜外麻醉行剖宫产手术的产妇,随机分为Ⅰ组,切皮前静脉注射氯胺酮0.3 mg/kg（用生理盐水稀释至10 ml） Ⅱ组,切皮前静脉注射生理盐水10 ml,每组各30例.记录两组用药前及用药后5、10、15、30min产妇的平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2） 观察两组新生儿出生后1、5 min的Apgar评分 记录两组产妇术后2、6、24 h的视觉模拟评分（VAS）、对麻醉的满意度及精神症状等不良反应发生情况.结果 两组用药前后HR、SpO2变化,新生儿出生后1、5 min的Apgar评分,术后各时间点VAS评分,不良反应发生情况两组比较差异均无统计学意义（P＞0.05）.用药后5、10 min的MAPⅡ组低于Ⅰ组（P＜0.05）,产妇对麻醉的满意度优良率Ⅰ组明显高于Ⅱ组（P＜0.05）.结论 小剂量氯胺酮用于剖宫产手术可以提高产妇对麻醉的满意度,对产妇及新生儿无明显不良影响.

Clinical observation of lowdose intravenous ketamine after epudial anaesthesia for cesarean section

Objective To evaluate the effects and safety of low-dose intravenous ketamine for caesarean section. Methods Sixty selective cesarean section patients were randomly divided into two groups： before operation to receive one of two intravenous regimens： 0. 3 mg/kg ketamine in 10 ml of normal saline （group Ⅰ ）, 10 ml of normal saline （group Ⅱ ）. The mean arterial pressure （MAP） ,heart rate （HR） and pulse oxygen saturation （SpO2 ） were recorded before and 5,10,15,30 min after adminstrating ketamine. Apgar scores, visual analog scales（VAS）, degree of satisfaction for anesthesia of patients and the adverse effects were observed after operation. Results The difference of HR, SpO2, Apgar scores,VAS and the adverse effects were similar between the two groups（ P 〉0.05 ） The MAP in group Ⅱ at 5 and 10 min after operation were significantly lower than that in group Ⅰ （ P 〈0.05）. The degree of satisfaction for anesthesia in patients of group Ⅰ were significantly higher than that in group Ⅱ（P 〈 0. 05 ）. Conclusions Low-dose intravenous ketamine for cesarean section before operation can enhance degree of satisfaction for anesthesia and has no adverse effect on parturients or neonatal.