摘要
目的:观察持续输注依托咪酯复合骶管麻醉对小儿血清皮质醇浓度的影响。方法:60例择期行尿道下裂修补术患儿,年龄5-6岁,ASAⅠ-Ⅱ级,随机分为依托咪酯组(A组),丙泊酚组(B组),各30例。入室后均静脉注射氯胺酮2 mg/kg,入睡后常规骶管阻滞,术中麻醉维持:A组泵注依托咪酯脂肪乳(22-25)μg/kg.min,B组泵注丙泊酚(8-10)mg/kg.h。分别在麻醉前(Ⅰ)、泵注依托咪酯脂肪乳/丙泊酚30min(Ⅱ)、术后即刻(Ⅲ)、术后12h(Ⅳ)、术后24h(Ⅴ)、术后48h(Ⅵ)抽静脉血,测量血清皮质醇水平。结果:Ⅱ、Ⅲ、Ⅳ、Ⅴ时点A组血清皮质醇浓度低于B组(P<0.05),两组血清皮质醇浓度于Ⅵ时点均恢复至麻醉前水平。结论:依托咪酯脂肪乳对小儿肾上腺皮质功能的抑制作用短暂,术后48h恢复至麻醉前水平,可以应用于小儿静脉麻醉维持。
Objective：To study the effects of Etomidate on pedo-adrenal cortex function.Metheods：60 children scheduled for hypospadia-neoplasty,aged 5-6,ASAⅠ-Ⅱ,randomly arranged into etomidate group（group A）,propofol group（group B） with 30 exaples in either group.After intravenous injiection ketamine 2 mg/kg,all children were did caudal anesthesia.Anesthesia was maintained with etomidate（22-25）μg/kg.min injection in group A or propofol（8-10） mg/kg.h in Group B.Blood sample were taken before induction（Ⅰ）,immediately after 30 minutes pump-injected of Etomidate/Propofol（Ⅱ） immediately,after operation（Ⅲ）,12hr（Ⅳ）,24hr（Ⅴ） and 48 hr（Ⅵ） after operation to measure plasma concentration of cortisol.Results：The concentration of cortisol of group B was significant higher than group B（P0.05） at Ⅱ- –Ⅴ,and restored to preoperative level in both groups at Ⅵ.Conclusion： Etomidate has some certain inhabit effects to adrenal cortex,it can be restored to baseline level at 48 hr after operation.Continuous infusion of etomidate was effective and safefor pedo-hypospadia neoplasty.
出处
《中国医药导刊》
2012年第3期431-432,共2页
Chinese Journal of Medicinal Guide
关键词
依托咪酯
复合麻醉
小儿
皮质醇
Eetomidate
Ggeneral Anesthesia
Cchildren
Ccortisol
