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目的:探讨丙泊酚与咪哒唑仑复合氯胺酮用于小儿心导管术麻醉的优缺点与安全性。方法:将2008年7月~2012年7月入住我院的100例行心导管术的先心病患儿按照抽签法随机地均分为A、B组,A组采用6 mg/(kg·h)丙泊酚+3 mg/(kg·h)氯胺酮维持,B组采用0.15 mg/(kg·h)咪达唑仑+3 mg/(kg·h)氯胺酮维持,比较两组麻醉效果、HR、SPO2、MAP、体动次数、停药唤醒时间及不良反应发生率。结果:对照组麻醉优良率为80.00%,小于观察组(100.00%)(P<0.05);两组术前MAP、HR差异无统计学意义(P>0.05),但股动脉穿刺时二者差异具有统计学意义(P<0.05),两组术中SPO2差异无统计学意义(P>0.05),两组体动次数、停药唤醒时间相比,具有统计学差异(P<0.05,P<0.01);对照组不良反应发生率为24.00%,明显大于观察组(10.00%),两组相比,差异具有显著的统计学意义(P<0.01)。结论:咪哒唑仑复合氯胺酮用于小儿心导管术麻醉效果显著,安全性高,值得在临床上加以推广并应用。
Objective: To investigate the advantages and disadvantages of anesthesia with propofol and midazolam combined with ketamine for pediatric cardiac catheterization. Methods: A total of 100 patients with congenital heart disease undergoing cardiac catheterization admitted to our hospital from July 2008 to July 2012 were randomly divided into groups A and B according to the random sampling method. A group was treated with 6 mg / (kg · h) ) Propofol + 3 mg / (kg · h) ketamine, group B was maintained with midazolam 0.15 mg / (kg · h) and ketamine 3 mg / (kg · h) , SPO2, MAP, frequency of physical activity, withdrawal time and the incidence of adverse reactions. Results: The excellent and good rate of anesthesia in the control group was 80.00%, less than that in the observation group (100.00%) (P <0.05). There was no significant difference in preoperative MAP and HR between the two groups (P> 0.05) (P <0.05). There was no significant difference in SPO2 between the two groups (P> 0.05). There was a significant difference between the two groups in the number of motor activities and the withdrawal time of withdrawal (P <0.05, P < 0.01). The incidence of adverse reactions in the control group was 24.00%, which was significantly higher than that in the observation group (10.00%). There was significant difference between the two groups (P <0.01). CONCLUSION: Midazolam combined with ketamine is effective in pediatric cardiac catheterization and has high safety. It is worth to be popularized and applied clinically.