摘要
目的:探讨小剂量舒芬太尼联合氯胺酮对高海拔地区先天性心脏病患儿手术麻醉诱导期血流动力学和脑氧饱和度的影响。方法:选取2016年3月至2020年5月青海红十字医院收治的先天性心脏病患儿120例,采用随机数字表法将患儿分为对照组和观察组,每组60例。对照组患儿给予氯胺酮基础麻醉,观察组患儿给予小剂量舒芬太尼联合氯胺酮基础麻醉,随后两组患儿均给予静脉复合药物诱导气管插管。观察两组患儿不同时间点[基础麻醉后(T_(0)),麻醉诱导后1 min(T_(1))、2 min(T_(2))及5 min(T_(3)),气管插管后1 min(T_(4))、2 min(T_(5))、5 min(T_(6))及10 min(T7)]的心率(HR)、平均动脉压(MAP)、每搏量指数(SVI)、心指数(CI)、体循环阻力指数(SVRI)和最大压力梯度(dp/dtmax)、脉压变异度(PPV)及脑氧饱和度(r Sc O_(2))。结果:与对照组相比,观察组患儿各时间点HR、MAP、SVRI、dp/dtmax和PPV明显降低,SVI、CI和r ScO2明显升高。其中,T_(0)-T7时,观察组患儿HR明显低于对照组;T_(0)-T_(2)时,观察组患儿MAP明显低于对照组;T_(1)-T_(6)时,观察组患儿SVI明显高于对照组;T_(1)-T_(2)时,观察组患儿CI明显高于对照组;T_(0)-T_(2)和T_(4)-T_(5)时,观察组患儿SVRI明显低于对照组;T_(0)-T_(1)时,观察组患儿dp/dtmax明显低于对照组;T_(0)-T_(5)时,观察组患儿PPV明显低于对照组;T_(0)-T_(2)时,观察组患儿r ScO2明显高于对照组,上述差异均有统计学意义(P<0.05)。结论:小剂量舒芬太尼联合氯胺酮更有利于维持高海拔地区先天性心脏病患儿手术麻醉诱导期血流动力学和脑氧饱和度的稳定。
OBJECTIVE:To probe into the effects of low-dose sufentanil combined with ketamine on hemodynamics and cerebral oxygen saturation during anesthesia induction in children with congenital heart surgery in high altitude areas.METHODS:Totally 120 children with congenital heart disease admitted into Qinghai Red Cross Hospital from Mar.2016 to May 2020 were extracted to be divided into the control group and the observation group vai the random number table,with 60 cases in each group.The control group was given basic ketamine anesthesia,while the observation group received low-dose sufentanil combined with ketamine.Both groups were given intravenous compound drugs to induce tracheal intubation.Heart rate(HR),mean arterial pressure(MAP),stroke volume index(SVI),cardiac index(CI),systemic resistance index(SVRI)and the maximum pressure gradient(dp/dtmax)and pulse pressure variation degree(PPV)and cerebral oxygen saturation(r Sc O_(2))at different time points[after basic anesthesia(T_(0)),1 min after anesthesia induction(T_(1)),2 min(T_(2))and 5 min(T_(3)),1 min after endotracheal intubation(T_(4)),2 min(T_(5)),5 min(T_(6))and 10 min(T7)]of two groups were observed.RESULTS:Compared with the control group,HR,MAP,SVRI,dp/dtmaxand PPV decreased significantly at each time point in the observation group,while SVI,CI and r ScO2 increased significantly.HR in the observation group was significantly lower than that in the control group from T_(0)to T7;MAP in the observation group was significantly lower than that in the control group from T_(0)to T_(2);SVI in the observation group was significantly higher than that in the control group from T_(1)to T_(6);CI in the observation group was significantly higher than that in the control group from T_(1)to T_(2);SVRI in the observation group was significantly lower than that in the control group from T_(0)to T_(2)and from T_(4)to T_(5);dp/dtmaxin the observation group was significantly lower than that in the control group from T_(0)to T_(1);PPV of the observation group was significantly lo
作者
张利亮
姚泽宇
谢玉海
ZHANG Liliang;YAO Zeyu;XIE Yuhai(Dept.of Anesthesiology,Qinghai Red Cross Hospital,Qinghai Xining 810000,China)
出处
《中国医院用药评价与分析》
2021年第2期151-154,159,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
青海省科技计划项目(No.2019-ZJ-7085)。
关键词
氯胺酮
舒芬太尼
先天性心脏病
高海拔地区
血流动力学
脑氧饱和度
Ketamine
Sufentanil
Congenital heart disease
High altitude areas
Hemodynamics
Cerebral oxygen saturation
