《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (04): 380-381.

• 临床研究 • 上一篇    下一篇

小剂量氯胺酮在无痛胃镜检查术中的应用

要小梅   

  1. 首都医科大学附属复兴医院麻醉科，北京市 100038
  • 收稿日期:2009-02-05 出版日期:2009-04-01 发布日期:2009-04-01

Application of Small Dose of Ketamine in Painless Gastroscopy

YAO Xiao-mei   

  1. The Department of Anesthesiology, Beijing Fuxing Hospital, Beijing 100038, China
  • Received:2009-02-05 Published:2009-04-01 Online:2009-04-01

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摘要： 目的 观察静脉小剂量氯胺酮联合舒芬尼与丙泊酚在无痛胃镜检查术中的应用效果。方法 拟在静脉全麻下接受胃镜检查术的62例患者随机分成对照组和氯胺酮组各31例。对照组采取持续静脉输注丙泊酚（靶控浓度3.0 μg/ml）和舒芬尼（负荷剂量0.15 μg/kg，维持剂量0.15 μg/kg/h）；氯胺酮组先静脉注射氯胺酮0.5 mg/kg，随后持续静脉输注丙泊酚（靶控浓度3.0 μg/ml）和舒芬尼（负荷剂量0.1 μg/kg，维持剂量0.1 μg/kg/h）。患者意识消失且生命体征平稳后开始实施胃镜检查操作。操作完成时停止给药。记录麻醉前、开始麻醉后1 min、置入胃镜时、放入胃镜后10 min及患者苏醒时的收缩压（SBP）和心率（HR）；记录在麻醉过程中需要特殊呼吸管理（SRM）、操作过程中出现身体扭动（BM）以及发生术后恶心呕吐（PONV）的患者数；记录麻醉苏醒时间（RT）。结果 两组患者在各时间点的SBP、HR以及在BM、RT及NV方面无显著性差异（ P>0.05）；对照组和氯胺酮组分别有8例和1例患者在置入胃镜前有一过性呼吸抑制，需要SRM（ P<0.01）。结论 静脉小剂量氯胺酮联合舒芬尼与丙泊酚是一种安全有效的方法。

关键词: 小剂量, 氯胺酮, 无痛胃镜检查术

Abstract: Objective To observe the effect of intravenous small dose of ketamine combined with continuous infusion of propofol and sufentanyl in painless gastroscopy.Methods 62 patients undergoing painless gastroscopy under intravenous anesthesia were randomly divided into the control group and ketamine group with 31 cases in each group. The cases of the control group were treated with continuous infusion of propofol (target controlled infusion rate: 3.0 μg/ml) and sufentanyl (loading dose: 0.15 μg/kg, basal rate 0.15 μg/kg/h); those of the ketamine group were treated with intravenous small dose of ketamine 0.5 mg/kg combined with continuous infusion of propofol (target controlled infusion rate: 3.0 μg/ml) and sufentanyl (loading dose: 0.1 μg/kg, basal rate 0.1 μg/kg/h). The procedure of gastroscopy was started when patients were in unconsciousness and their vital signs were stable, and the infusion of medicine was stopped when the gastroscopy was finished. The systolic blood pressure (SBP) and heart rate (HR) at the time of before anesthesia, 1 minute after anesthesia, inserting the gastroscope, 10 minutes after inserting the gastroscope, and recovering from the anesthesia were recorded. The cases needing special respiratory management (SRM), displaying body movement (BM) in gastroscopy and post-operative nausea and vomiting (PONV) were recorded. The recovery time (RT) after gastroscopy was also recorded.Results No significant difference was found in SBP, HR, BM, PONV and RT between two groups ( P>0.05). Eight cases in the control group and one case in the ketamine group needed SRM before inserting the gastroscope due to transient respiratory depression ( P<0.01).Conclusion The application of intravenous small dose of ketamine combined with continuous infusion of propofol and sufentanyl in painless gastroscopy is effective and safe.

Key words: small dose, ketamine, painless gastroscopy