小剂量氯胺酮复合丙泊酚-瑞芬太尼静脉麻醉在隆乳术中应用.docVIP

小剂量氯胺酮复合丙泊酚-瑞芬太尼静脉麻醉在隆乳术中应用[摘要]目的:观察小剂量氯胺酮复合丙泊酚-瑞芬太尼靶控输注用于隆乳术麻醉的效果和意义。方法:40例患者随机分为丙泊酚复合瑞芬太尼靶控输注组(PR组,n=20)和丙泊酚瑞芬太尼靶控输注联合氯胺酮组(PR-K组,n=20)。两组诱导起始效应室靶浓度相同,PR-K组于诱导时单次静注氯胺酮0.4 mg/kg。观察并比较两组患者麻醉效果及血流动力学变化,记录丙泊酚和瑞芬太尼用量。结果:两种麻醉方法均取得较满意的麻醉效果;PR-K组较PR组诱导迅速,血流动力学波动小,且丙泊酚和瑞芬太尼诱导用量少。结论:单次静注小剂量氯胺酮诱导可安全用于隆乳术麻醉,兼具良好的麻醉效应和经济效益。 [关键词]氯胺酮;麻醉;靶控输注;隆乳术 [中图分类号]R655.8[文献标识码]A[文章编号]1008-6455(2010)02-0173-03 Application of intravenous anesthesia with low-dose ketamine in addition to propofol and remifentanil in augmentation mammaplasty CHENG Dan-dan1,WANG Zhi-hua1,YANG Cen1,LI Yong2,SUN Yan-yan1 (1. Department of Anesthesiology; 2. Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’ an 710032, Shaanxi,China) Abstract: ObjectiveTo investigate the anesthesia efficacy and significance of a single low-dose of intravenous ketamine combined with propofol and remifentanil in augmentation mammaplasty.MethodsForty patients schedueled for augmentation mammaplasty were divided into two groups randomly: general anesthesia with target-controlled infusion of propofol and remifentanil (group PR, n=20) and general anesthesia with target-controlled infusion of propofol and remifentanil combined with ketamine (group PR-K, n=20).All patients were induced with the same initial target concentration of propofol and remifentanil in the effect-site, while the patients in group PR-K acceped a single dose of 0.4 mg/kg ketamine intravenously. The anesthesia efficacy and hemodynamic changes were observed and the consumptions of propofol and remifentanil during induction and maintenance of anesthesia were compared between two groups. ResultsThe anesthesia efficacy of all patiens were satisfactory. Compared with those of group PR, the patients of group PR-K were induced more rapidly and had less hemodynamic changes. The consumptions of propofol and remifentanil of group PR-K were less than that in group PR. Conclusion A single low-dose of intravenous ketamine can be