地佐辛和氯胺酮用于紫绀型复杂先天性心脏病小儿导管造影麻醉对照研究

发布时间：2018-03-18 03:06

本文选题：地佐辛　切入点：氯胺酮　出处：《中国实用儿科杂志》2015年12期 　论文类型：期刊论文

【摘要】：目的对比观察地佐辛和氯胺酮用于紫绀型复杂先天性心脏病(CCHD)导管造影麻醉的临床效果和安全性。方法 2014年1月至2015年4月清华大学第一附属医院择期行心导管造影术的6岁以下CCHD患儿64例,用抽签法随机分为地佐辛组(D组)和氯胺酮组(L组),每组32例。D组静注地佐辛0.2 mg/kg,L组静注氯胺酮2.0 mg/kg,静脉诱导后置入喉罩,以吸入2.0%~2.5%七氟烷维持麻醉。观察注药后患儿入睡时间(T1)、拔管后面罩辅助通气时间(T2)、苏醒时间(T3)、气道痉挛、呼吸抑制、躁动、疼痛及恶心呕吐等不良反应。结果 D组患儿T1长于L组(P0.05),T3短于L组(P0.05),诱导期或者拔管后血氧饱和度下降20%和吸痰2次以上的例数明显少于L组(P0.05),余差异无统计学意义。结论地佐辛0.2 mg/kg静脉注射可安全用于紫绀型CCHD患儿导管造影麻醉,可提供满意的术前镇静和术后镇痛,且呼吸道不良反应发生率低于氯胺酮。
[Abstract]:Objective to compare the clinical efficacy and safety of dizosin and ketamine in the anesthesia of CCHD catheterization in patients with cyanotic complex congenital heart disease. Methods from January 2014 to April 2015, the first affiliated Hospital of Tsinghua University selected cardiac conduction. 64 cases of children under 6 years of age with CCHD underwent tube radiography, Group D (group D) and group L (ketamine group) were randomly divided into two groups: group D (n = 32) and group D (n = 32). Group D was given intravenous injection of ketamine (0.2 mg / kg 路kg ~ (-1)) by intravenous injection of ketamine 2.0 mg / kg, and then placed into larynx mask after intravenous induction. The anesthesia was maintained by inhaling 2.5% sevoflurane. The time of falling asleep after injection was observed, the time of mask assisted ventilation after extubation was T _ 2, the time of recovery was T _ 3, the airway spasm, respiratory inhibition and restlessness were observed. Results the T 1 of group D was longer than that of group L (P 0.05) and T3 was shorter than that of group L (P 0.05). The number of patients with lower blood oxygen saturation (20%) and more than two times of sputum aspiration in induced stage or after extubation was significantly lower than that in group L (P 0.05), and there was no statistical difference. Conclusion Dizosin 0.2 mg/kg intravenously can be safely used in anesthetic catheterization in children with cyanotic CCHD. It can provide satisfactory preoperative sedation and postoperative analgesia, and the incidence of adverse respiratory reactions is lower than ketamine.
【作者单位】：清华大学第一附属医院麻醉科;
【分类号】：R726.1

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