特重烧伤患者的临床麻醉体会

目的:探讨特重烧伤患者的麻醉处理。方法:回顾分析26例特重烧伤患者72例次手术麻醉处理。1组(26例次)采用氯胺酮、γ-羟丁酸钠静脉复合麻醉;2组(46例次)采用异丙酚、氯胺酮静脉复合麻醉,对麻醉处理结果进行分析。结果:所有病例均顺利完成手术2组术中血流动力学更平稳,其麻醉诱导时间,苏醒时间显著快于1组,术后恶心、呕吐,谵妄,恶梦等精神症状及术中知晓发生率显著减少。结论:特重烧伤患者应用异丙酚、氯胺酮静脉复合麻醉术中循环稳定,麻醉诱导迅速,苏醒快,不良反应少。

Experience of anesthesia for extensive severely burned patients

Objective: To study the anesthesia for extensive severely burned patients.Methods: Retrospective analysis of 72 times of anesthesia for 26 patients with extensive severely burns.Patients undergoing anesthesia were divided into two groups,group I and group II,by randomization.Patients in group I(26 times) practised combined intravenous anesthesia using ketamine and sodium gamma-hydroxybutyrate;patients in group II(46times) practised combined intravenous anesthesia using propofol and ketamine.The results were studied.Results: All cases were completed operation smoothly under the anesthesia.Hemodynamics of patients in group II was steadier than that in group I,time of induction and postoperative recovery in group II was significantly shorter than that in group I.Postoperative nausea,sick,delirium,nightmare and so forth neurological symptoms reduced significantly in patients in group II,analgesia effect of patients in group II was much better.Conclusion: Combined intravenous anesthesia using propofol and ketamine for extensive severely burned patients has characteristics of stable hemodynamics,quick induction and recovery,less side effects.