小型猪心内直视手术两种麻醉方法的对比研究

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1、小型猪心内直视手术两种麻醉方法的对比研究作者：宋兵，祁亮，任旭东，张巧燕，王玲，柳德斌【摘要】目的比较两种麻醉方法在小型猪心内直视手术中的麻醉效果。方法小型猪36例，随机分为两组：K组18例，诱导插管用氯胺酮3mg/kg和戊巴比妥20mg/kg，全麻维持用氯胺酮5mg/(kg·h)、戊巴比妥8～10mg/(kg·h)和哌库溴铵0.1mg/(kg·h)。F组18例，诱导插管用戊巴比妥30mg/kg，全麻维持用芬太尼15～20μg/(kg·h)，戊巴比妥8～10mg/(kg·h)和哌库溴铵0.1mg/(kg·h)。记录各期用药前后的生命体征、血流动力学、麻醉效果和延迟拔管等情况。结果K组

2、全部存活，F组死亡2例;K组诱导时间和呼吸机辅助时间均少于F组(P<0.01和P<0.001);K组的心率、呼吸频率和平均动脉压较F组平稳(P<0.05);全麻效果评价亦优于F组(P<0.05)。结论小剂量氯胺酮复合戊巴比妥麻醉起效快，对呼吸和循环抑制轻微，无延迟拔管，较为安全。【关键词】心内直视手术;氯胺酮;芬太尼;戊巴比妥;小型猪ABSTRACT:ObjectiveTocomparetheanestheticeffectsofketaminepluspentobarbitalandfentanylpluspentobarbitalforopenhearts

3、urgeryinminipigs.MethodsThirtysixminipigs11wererandomlydividedintoketamine(K)groupandfentanyl(F)group.EighteenminipigsinKgroupreceivedketamine3mg/kgandpentobarbital20mg/kgintramuscularlyforinductionandintubation,thenwereintravenouslygivenketamine5mg/kg·h),pentobarbital8-10mg/(kg·h)andpipecuron

4、ium0.1mg/(kg·h)formaintenance.Theother18inFgroupreceivedpentobarbital30mg/kgintramuscularlyforinductionandintubation,thenwereintravenouslygivenfentanyl15-20μg/(kg·h),pentobarbital8-10/(kg·h)andpipecuronium0.1mg/(kg·h)formaintenance.Duringexperimentaltreatment,vitalsignsweremonitoredandhemodynam

5、icparameterswererecorded,theanestheticeffectivenesswasassessed,andpostponedextubationwasobservedinallminipigsofbothgroups.ResultsAlltheminipigsinKgroupsurvivedtheoperation,and2casesinFgroupdied.ThetimeofanesthesiainductionandventilationassistanceingroupKwasshorterthanthatingroupF(P<0.01andP&

6、lt;0.001,respectively).Heartrate,respiratoryrateandmeanarterypressureweremorestableintheformergroupthaninthelatter(P<0.05).Inaddition,KgrouphadsignificantlyhigherscoreforanestheticeffectassessmentthanFgroup(P<0.05).ConclusionLowdoseketaminepluspentobarbitaltakeseffectsrapidlyduringinduct

7、ion,andhas11aslightinhibitoryeffectonrespiratoryandcardiacsystemwithoutpostponedextubation.　　KEYWORDS:openheartsurgery;ketamine;fentanyl;pentobarbital;minipig　目前，国内外在猪心内直视手术中的麻醉管理仍面临着不少的问题，有较高的并发症和死亡率[12]。因此，优化麻醉方案对减少围术期并发症，保证实验研