氯胺酮复合咪达唑仑静脉麻醉在各年龄段地震创伤手术中的应用
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摘要
目的观察氯胺酮复合咪达唑仑静脉麻醉在各年龄段地震创伤手术中的应用效果。方法因地震创伤急需行清创术的伤员56例,按年龄段分为三组,通过静脉依次给予咪达唑仑0.05～0.1mg/kg、氯胺酮1～2mg/kg,术中据情况追加氯胺酮0.5～1mg/kg。观察记录各组伤员术中MAP、HR、R及SPO2的变化,记录诱导及苏醒时间以及术中和术后发生不良反应的情况。结果各组伤员术中MAP、HR、R及SPO2维持较为平稳,诱导及苏醒均较为迅速,术中及术后不良反应发生较少。结论氯胺酮复合咪达唑仑静脉麻醉可为地震创伤手术提供一种安全、有效及副作用少的麻醉方法。
Objective To observe the clinical effect of ketamine-midazolam intravenous anesthesia in patients with different ages undertaking earthquake trauma operation.Methods Fifty-six earthquake victims treated with debridement were divided into three age groups.Midazolam 0.05～0.1mg/kg and ketamine 1～2mg/kg intravenous injection were used for induction and maintenance of anesthesia.Repeat IV ketamine dose of 0.5～1.0mg/kg were given for prolonged procedures.The mean arterial pressure(MAP),heart rate(HR),respiratory frequency(R) and Pulse Oxygen Saturation(SPO2) during anesthesia were recorded.The induction time and consciousness recovery time were recorded.The side-effect during ansesthesia were investigated.Results The MAP,HR,R and SPO2 were stable in the three groups.The induction time and consciousness recovery time in each group was short.No severe side-effect happened in all groups.Conclusion Ketamine-midazolam intravenous anesthesia is safe,effective and with a low incidence of major adverse effcts for patients with different ages undertaking earthquake trauma operation.
Objective To observe the clinical effect of ketamine-midazolam intravenous anesthesia in patients with different ages undertaking earthquake trauma operation.Methods Fifty-six earthquake victims treated with debridement were divided into three age groups.Midazolam 0.05～0.1mg/kg and ketamine 1～2mg/kg intravenous injection were used for induction and maintenance of anesthesia.Repeat IV ketamine dose of 0.5～1.0mg/kg were given for prolonged procedures.The mean arterial pressure(MAP),heart rate(HR),respiratory frequency(R) and Pulse Oxygen Saturation(SPO2) during anesthesia were recorded.The induction time and consciousness recovery time were recorded.The side-effect during ansesthesia were investigated.Results The MAP,HR,R and SPO2 were stable in the three groups.The induction time and consciousness recovery time in each group was short.No severe side-effect happened in all groups.Conclusion Ketamine-midazolam intravenous anesthesia is safe,effective and with a low incidence of major adverse effcts for patients with different ages undertaking earthquake trauma operation.
引文
[1]王正国.灾难和事故的创伤救治[M].北京:人民卫生出版社,2005:8-12,47-48.
[2]张宗琏,蒋小燕.地震灾害的紧急救援[J].中国全科医学,2004,7(24):1810-1811.
[3]Mulvey JM,Qadri AA,Maqsood MA.Earthquake injuries and the use ofketamine for surgical procedures:the Kashmir experience[J].Anaesth In-tensive Care,2006,34(4):490-494.
[4]庄心良,曾因明,陈伯鉴.现代麻醉学[M].第3版.北京:人民卫生出版社,2003:475-480,500-501.
[5]暴桂萍,张艳花.氯胺酮复合瑞芬太尼和咪达唑仑用于小儿全凭静脉麻醉[J].医学信息手术学分册,2007,20(2):135.
[6]庄少惠,陈瑞华.氯胺酮和咪达唑仑联合应用于小儿麻醉的临床观察[J].医药世界,2006,8(6):87-88.
[7]Erk G,Ornek D,Dnmez NF,et al.The use of ketamine or ketamine-midazolam for adenotonsillectomy[J].Int J Pediatr Otorhinolaryngol,2007,71(6):939-940.
[2]张宗琏,蒋小燕.地震灾害的紧急救援[J].中国全科医学,2004,7(24):1810-1811.
[3]Mulvey JM,Qadri AA,Maqsood MA.Earthquake injuries and the use ofketamine for surgical procedures:the Kashmir experience[J].Anaesth In-tensive Care,2006,34(4):490-494.
[4]庄心良,曾因明,陈伯鉴.现代麻醉学[M].第3版.北京:人民卫生出版社,2003:475-480,500-501.
[5]暴桂萍,张艳花.氯胺酮复合瑞芬太尼和咪达唑仑用于小儿全凭静脉麻醉[J].医学信息手术学分册,2007,20(2):135.
[6]庄少惠,陈瑞华.氯胺酮和咪达唑仑联合应用于小儿麻醉的临床观察[J].医药世界,2006,8(6):87-88.
[7]Erk G,Ornek D,Dnmez NF,et al.The use of ketamine or ketamine-midazolam for adenotonsillectomy[J].Int J Pediatr Otorhinolaryngol,2007,71(6):939-940.
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