摘要
目的:观察异丙酚-氯胺酮静脉复合麻醉在不同配伍剂量的麻醉效果以及副作用,探索出一种适合于腹部外科手术安全、有效的静脉麻醉方法。方法:选择临床胆囊切除手术100例,随机分为5个不同药物配伍剂量试验组,每组20例:P6K1组;P8K1组;P8K1.5组;P8K2组; P10K1组。P表示异丙酚,K表示氯胺酮,阿拉伯数值表示该组内P或K静脉输注剂量[mg／(kg·h)],观察麻醉期间BIS、HRV以及MAP、HR, 副作用等。结果:P10K1组BIS、HRV麻醉全程最为稳定,P6K1组BIS、HRV明显回升(P<0．05),P8K2组HRV波动明显(P<0．05),且BIS呈逐渐升高趋势;P6K1组的MAP升高时间明显延长(P<0．05);P8K2组MAP波动数值最大;P10K1组HR下降明显(P<0．05);P8K2组停药后的刺激反应时间和麻醉苏醒时间明显延长(P<0．05),副作用也明显增多(P<0．05),而P10K1组的恶心、呕吐相对较少。结论:异丙酚8- 10 mg／(kg·h),复合氯胺酮1-1．5 mg／(kg·h)可以获得较为满意的睡眠／麻醉深度,用于腹腔内手术麻醉,尚须注意减轻伤害性刺激的影响。
Objective：To observe the effects and side effect on abdominal surgery patients of intravenous propofol and ketamine anesthesia in different dose prescriptions,and to explore a usable methed and for abdominal surgery. Methods： 100 cases were randomly divided into five groups with different dose prescriptions. Results：BIS. HRV increased significantly in the intravenous 6 mg/（kg·h）bolus of propofol and 1 mg/（kg·h） bolus of ketamine mixture group（P〈0.05）, H RV changed significantly and BIS increased gradually in the intravenous 8 mg/（kg·h）bolus of propofol and 2 mg/（kg·h）bolus of ketamine mixture group（P〈0.05） ,while BIS,HRV changed less 10 mg/（kg·h）bolus of propofol and 1mg/ （kg·h）bolus of ketamine mixture group. MAP changed significantly in 8 mg/（kg·h）propofol and 2 mg/（kg·h）bolus of ketamine mixture group. HR increased significantly in the intravenous 10 mg/（kg·h）bolus of propofol and 1 mg/（kg·h）bolus of ketarnine mixture group（P〈 0. 05）. The drug withdrawal stimulation reaction time and recovery time and side effect increased significantly in the intravenous 8 mg/（kg·h） bolus of propofol and 2 rag/（kg·h）bolus of ketamine mixture group（P〈0.05）. Compared with others groups, nausea-vomiting relative less in the intravenous 10 mg/（kg·h）bolus of propofol and ling/（ kg·h）bolus of ketamine mixture group. Conclusions： The 8-10 mg/（ kg . h）bolus of propofol and 1-1.5 mg/（ kg·h） bolus of ketamine mixture may be a safe, practical alternative for general anesthesia in patients undergoing abdominal region operation.
出处
《中国冶金工业医学杂志》
2006年第1期14-16,共3页
Chinese Medical Journal of Metallurgical industry
