亚麻醉剂量氯胺酮复合丙泊酚在小儿无痛纤支镜检查术中的应用

摘要

[Objective] To investigate the application of sub anesthetic dose of ketamine combined with propofol in pediatric painless fiberoptic bronchoscopy(FB). [Methods] Sixty children scheduled for FB were divided into three groups. Group Ⅰ was injected intravenously with propofol 2mg/kg. Group Ⅱ was injected intravenously with fentanyl 1 μg/kg and then with propofol 2mg/kg slowly 5min later. Group Ⅲ was given ketamine 0.5mg/kg, and then with propofol 2mg/kg slowly 5min later. Mean arterial pressure(MAP) , heart rate (HR), respiration rate(RR) and pulse oxygen saturation(SpO2) were recorded before anesthesia(T0),before operation(T1 ), during operation(T2) and after operation(T3 ). Propofol dose, the wake up time and adverse reaction were observed. [Results] Compared with T0, the HR, MAP, RR and SpO2 in Group Ⅰ and Ⅱ decreased significantly at T1 (p ＜0.05). Compared with T0 , there was no significant difference in the above parameters in Group Ⅲ among T1 , T2 and T3 (p ＞0.05). The consumption of propofol in Group Ⅱ and Group Ⅲ was lower than that in Group Ⅰ (p ＜0.05). The rate of respiratory inhibition in Group Ⅱ was higher than that in Group Ⅲ , and there was significant difference(p ＜0. 05). [Conclusion] Sub anesthetic dose of ketamine combined with propofol for pediatric painless fiberoptic bronchoscopy has satisfactory effect and few side reactions, so it is a safe and effective combination medication method.%[目的]研究亚麻醉剂量氯胺酮复合丙泊酚在小儿无痛纤维支气管镜(纤支镜)检查术中的应用.[方法]拟行无痛纤支镜检术患儿60例,按随机数字表法分为3组:Ⅰ组患者予丙泊酚2 mg/kg缓慢静脉注射;Ⅱ组先予静脉注射芬太尼1 ug/kg,5 min后缓慢静脉注射丙泊酚2 mg/kg,Ⅲ组先予氯胺酮0.5 mg/kg,5 min后缓慢静脉注射丙泊酚2 mg/kg.观察3组患者在麻醉前(T0)、操作前(T1)、操作时(T2) 以及术毕(T3)的心率 (HR)、血压(MAP)、血氧饱和度(SpO2)、呼吸频率(RR)以及丙泊酚用药剂量、睁眼时间及不良反应的发生情况.[结果]Ⅰ组,Ⅱ组HR,MAP,RR,SpO2于T1时间点均较T0明显下降(P<0.05),Ⅲ组各参数于T1,T2,T3各时间点与T0比较差异均无显著性(P>0.05).Ⅱ组,Ⅲ组丙泊酚用药量较Ⅰ组明显减少(P<0.05),Ⅱ组呼吸抑制发生率明显高于Ⅲ组,且差异有显著性(P<0.05).[结论]亚麻醉剂量氯胺酮复合丙泊酚静脉麻醉应用于小儿纤支镜检查术,麻醉效果满意且不良反应较少,是一种安全有效的配伍用药方式.