本文關(guān)鍵詞： 右美托咪啶 丙泊酚 氯胺酮 小兒 視網(wǎng)膜母細胞瘤 化療　出處：《武警醫(yī)學(xué)》2016年11期 　論文類型：期刊論文

【摘要】：目的評價右美托咪定與丙泊酚單獨復(fù)合或聯(lián)合復(fù)合氯胺酮用于視網(wǎng)膜母細胞瘤(retinoblastoma,RB)患兒經(jīng)股動脈穿刺行眼動脈局部化療的麻醉效果,比較幾種用藥方法的安全性與可行性。方法擇期經(jīng)股動脈穿刺行眼動脈局部化療的RB患兒60例,隨機分為3組(n=20):D組、P組和DP組。所有患兒入室后靜脈注射阿托品0.02 mg/kg和氯胺酮2.0mg/kg麻醉誘導(dǎo),同時D組給予右美托咪定1.0μg/(kg·h),P組給予丙泊酚10 mg/(kg·h),DP組給予右美托咪定0.5μg/(kg·h)復(fù)合丙泊酚5 mg/(kg·h),分別泵注維持至術(shù)畢。記錄患兒入室(T_0)、手術(shù)開始即刻(T_1)、手術(shù)后10 min(T_2)、化療藥注射即刻(T_3)、術(shù)畢即刻(T_4)、蘇醒即刻(T_5)各時間點患兒BIS、NBP、HR、RR和SpO_2,記錄各組患兒氯胺酮總用量和阿托品追加次數(shù)、手術(shù)時間、蘇醒時間、呼吸抑制和術(shù)后躁動等不良反應(yīng)的發(fā)生情況。結(jié)果與T_0比較,三組患兒在T_2,3,4時BIS值降低(P0.05),P組T_3,4時NBP降低(P0.05)。三組HR、RR和SpO_2各時間點差異無統(tǒng)計學(xué)意義。與D組比較,P組和DP組氯胺酮總用量減少(P0.05),追加次數(shù)減少(P0.01)。P組呼吸抑制率明顯高于D組與DP組(P0.01)。三組手術(shù)時間、蘇醒時間及阿托品使用率比較差異無統(tǒng)計學(xué)意義。所有患兒均未發(fā)生蘇醒期躁動。結(jié)論在RB患兒經(jīng)股動脈行眼動脈局部化療的手術(shù)中,采用氯胺酮誘導(dǎo),繼以右美托咪定0.5μg/(kg·h)與丙泊酚5 mg/(kg·h)聯(lián)合泵注維持可產(chǎn)生良好的鎮(zhèn)靜鎮(zhèn)痛效果,且不良反應(yīng)發(fā)生率低,是較適宜的麻醉組合。
[Abstract]:Objective to evaluate the effect of dexmetomidine and propofol alone or combined with ketamine on retinoblastoma of retinoblastoma. The anesthetic effect of ophthalmic artery local chemotherapy through femoral artery puncture was compared and the safety and feasibility of several methods were compared. Methods 60 cases of RB patients who underwent ophthalmic artery local chemotherapy via femoral artery puncture were selected. They were randomly divided into 3 groups: group P and group DP. All the children were anesthetized by intravenous injection of atropine 0.02 mg/kg and ketamine 2.0 mg / kg. At the same time, group D was given propofol (10 mg/(kg 路h). In the DP group, dexmetomidine 0.5 渭 g / kg 路h) combined with propofol 5 mg/(kg 路hU was administered to the patients until the end of operation. Immediately after operation, T1 was given, and 10 minutes after operation, the patients were treated with BIS. The patients had BIS at each time point after the injection of chemotherapeutic drugs, and immediately after the operation, and immediately after the operation, and immediately after the operation, the patients were treated with T _ 4, and the patients were treated with T _ (5) at each time point after the operation. The total dosage of ketamine, the times of addition of atropine, the time of operation and the time of recovery were recorded. Results compared with TCI, the BIS of the three groups was lower than that of the control group (P 0.05 and P < 0.05), and the BIS value of the three groups was lower than that of the control group (P 0.05 and P < 0.05). 4:00 NBP decreased P0.05. There was no significant difference in HRRR and SpO_2 between the three groups. Compared with group D, the total dosage of ketamine in P group and DP group was decreased (P 0.05). The rate of respiratory inhibition in group P was significantly higher than that in group D and group DP. There was no significant difference in recovery time and atropine usage rate. No restlessness occurred in all children. Conclusion ketamine is used to induce local chemotherapy of ophthalmic artery in RB patients. The combination of dexmetomidine (0.5 渭 g / kg 路h) and propofol (5 mg/(kg 路h) could produce good sedative and analgesic effects, and the incidence of adverse reactions was low. It is a more suitable combination of anesthesia.
【作者單位】： 武警總醫(yī)院麻醉科;
【分類號】：R614;R739.7
【正文快照】： 視網(wǎng)膜母細胞瘤(retinoblastoma,RB)是一種常見的先天性腫瘤,其全身化療的不良反應(yīng)較大、針對性不強。近年來,經(jīng)股動脈穿刺行眼動脈局部化療的技術(shù)開展?jié)u漸增多,其操作精細,需要絕對制動,但因小兒一般不能耐受股動脈穿刺時的疼痛以及離開家長后的恐慌,不能安靜地配合手術(shù),常需

【相似文獻】

相關(guān)期刊論文 前1條

1 夏兆驥;王大玫;李健寧;;視網(wǎng)膜母細胞瘤術(shù)后畸形的修復(fù)[J];中華整形燒傷外科雜志;1990年02期

，

本文編號：1481908