小型猪心内直视手术两种麻醉方法的对比研究_临床医学论文.docVIP

小型猪心内直视手术两种麻醉方法的对比研究_临床医学论文 小型猪心内直视手术两种麻醉方法的对比研究_临床医学论文 作者：宋兵，祁亮，任旭东，张巧燕，王玲，柳德斌 【摘要】 目的 比较两种麻醉方法在小型猪心内直视手术中的麻醉效果。方法 小型猪36例，随机分为两组：K组18例，诱导插管用氯胺酮3mg/kg和戊巴比妥20mg/kg，全麻维持用氯胺酮5mg/(kg·h)、戊巴比妥8～10mg/(kg·h)和哌库溴铵0.1mg/(kg·h)。F组18例，诱导插管用戊巴比妥30mg/kg，全麻维持用芬太尼15～20μg/(kg·h)，戊巴比妥8～10mg/(kg·h)和哌库溴铵0.1mg/(kg·h)。记录各期用药前后的生命体征、血流动力学、麻醉效果和延迟拔管等情况。结果 K组全部存活，F组死亡2例;K组诱导时间和呼吸机辅助时间均少于F组(0.01和0.001);K组的心率、呼吸频率和平均动脉压较F组平稳(0.05);全麻效果评价亦优于F组(0.05)。结论 小剂量氯胺酮复合戊巴比妥麻醉起效快，对呼吸和循环抑制轻微，无延迟拔管，较为安全。 【关键词】 心内直视手术;氯胺酮;芬太尼;戊巴比妥;小型猪 ABSTRACT: Objective To compare the anesthetic effects of ketamine plus pentobarbital and fentanyl plus pentobarbital for open heart surgery in minipigs. Methods Thirtysix minipigs were randomly divided into ketamine (K) group and fentanyl (F) group. Eighteen minipigs in K group received ketamine 3mg/kg and pentobarbital 20mg/kg intramuscularly for induction and intubation, then were intravenously given ketamine 5mg/kg·h), pentobarbital 8-10mg/(kg·h) and pipecuronium 0.1mg/(kg·h) for maintenance. The other 18 in F group received pentobarbital 30mg/kg intramuscularly for induction and intubation, then were intravenously given fentanyl 15-20μg/(kg·h), pentobarbital 8-10/(kg·h) and pipecuronium 0.1mg/(kg·h) for maintenance. During experimental treatment, vital signs were monitored and hemodynamic parameters were recorded, the anesthetic effectiveness was assessed, and postponed extubation was observed in all minipigs of both groups. Results All the minipigs in K group survived the operation, and 2 cases in F group died. The time of anesthesia induction and ventilation assistance in group K was shorter than that in group F (0.01 and 0.001, respectively). Heart rate, respiratory rate and mean artery pressure were more stable in the former group than in the latter (0.05). In addition, K group had significantly higher score for anesthetic effect assessment than F group (0.05). Conclusion Lowdose ketamine plus pentobarbital takes effects rapidly during induction, and has a slight i