摘要
目的 :探讨氯胺酮复合异丙酚辅助颈丛阻滞用于前入路颈椎手术 ,对通气功能及呼吸动力学的影响。方法 :32例择期行前入路颈椎手术患者 ,在颈丛阻滞后随机分为两组 ,每组 1 6例 , 组和 组分别静注异丙酚氯胺酮复合液和单纯异丙酚维持镇静于 Ramsay ～ 级。监测静脉给药前、给药后 5、1 5、30、4 5 min以及术毕通气功能和呼吸动力学参数 :吸入潮气量(VTins)、呼出潮气量 (VTexp)、吸气峰流速 (PIFR)、呼气峰流速 (PEFR)、吸气峰压 (PIP)、气道平均压 (PAWmean)、呼吸驱动力(P0 .1 )、PEEP、内源性 PEEP、食道压力 (ΔPES)、压力时间乘积 (PTP)、病人呼吸功 (WOBP)、频率 /潮气量比值 (f/ VT)、肺动力顺应性 (Cdyn)、分钟通气量 (VE)、呼吸频率 (RR)、气道阻力 (RAWE)。结果 :两组间各时点的各参数比较 ,差异均无统计学意义(P >0 .0 5 )。两组注药后各时点 PIFR、PEFR、PIP、PAWmean、PEEP、内源性 PEEP、ΔPES、VE与注药前相比 ,无统计学意义 (P >0 .0 5 )。但注药后 VTins、VTexp、Cdyn较注药前显著减少或下降 ,RR显著增快 ,P0 .1 、PTP、WOBP、f/ VT、RAWE显著增高或增加 (P <0 .0 5 ) ,至术毕时各参数均恢复到注药前水平。结论 :异丙酚复合少量氯胺酮辅助颈丛阻滞用于颈椎手术 ,对通气功能及呼吸动力?
Objective:To study the effect of propofol ketamine on ventilation function and respiratory mechanics during cervical plexus block for cervical vertebra surgery Methods:32 patiants having undergone elective cervical vertebra surgery were randomly divided into two groups (n=16) after cervical plexus block : Group Ⅰ received propofol ketamine and Group Ⅱ received propofol . The parameters of ventilation function and respiratory mechanics were monitored before and 5,15,30,45 min after intravenous injection propofol ketamine and propofol and when the surgery was concluded. Result:There were not statistical differences in all parameters of each time point between two groups(P>0.05);The peak inspiratory and expiratory flow rate,peak inspiratory pressure,mean airway pressure,PEEP,endogenic PEEP,esophageal pressure,minute expiratory volume showed no statistical differences before and each time point after intravenous injection propofol ketamine and propofol(P>0 05); After intravenous injection propofol ketamine and propofol the inspiratory and cervical plexus block for cervical vertebra surgery .expiratory tidal volume,dynamic compliance significantly decreased and the respiratory rate , respiratory drive,pressure time product,work of patient breathing,frequency/tidal volume,airway resistance significantly increased(P<0 05).Conclusion:Propofol ketamine can produce significant depression for ventilation function and respiratory mechanics during cervical plexus block for cervical vertebra surgery.
出处
《广西医科大学学报》
CAS
2003年第2期192-194,共3页
Journal of Guangxi Medical University
