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目的 :观察异丙酚靶控输注用于小儿心导管治疗术对呼吸和循环功能的影响、术后恢复情况以探讨其可行性。方法 :3 0例患儿随机分两组 :P组 ,行异丙酚靶控输注 ,效应室浓度先从 2 μg/ml开始 ,2min后增至 5～ 6μg/ml,待心导管进入股静脉或股动脉后 ,浓度减至 2～ 3 μg/ml。K组 ,行氯胺酮微泵持续输注 ,开始为 5 0～ 60 μg .kg-1.min-1,待心导管进入股动脉或股静脉后 ,浓度减至 3 0 μg .kg-1.min-1。测定术前、注药后 2min、5min、术始、术中刺激最强时、术毕时的心率、平均动脉压、血氧饱和度、呼吸频率和每分钟通气量。停麻药后观察耳垂反应 ;术后观察唤名反应和完全清醒的时间。结果 :异丙酚靶控输注组组内心率、血压、呼吸频率、每分钟通气量数值 ,麻醉后各时段与麻醉前相比较 ,差异无显著性。术后观察耳垂反应、唤名反应和完全清醒的时间均明显少于氯胺酮持续输注组。结论 :异丙酚靶控输注用于小儿心导管治疗术的麻醉术中稳定 ,术后恢复平稳 ,可以安全地应用小儿心导管治疗术。
Objective: To observe the effects of propofol target-controlled infusion on respiration and circulatory function in pediatric cardiac catheterization and the postoperative recovery to explore its feasibility. Methods: Totally 30 children were randomly divided into two groups: Group P, target-controlled infusion of propofol was used. The concentration of effector cells began at 2 μg / ml and increased to 5-6 μg / ml after 2 minutes. After the vein or femoral artery, the concentration was reduced to 2 ~ 3 μg / ml. K group, line ketamine micropump continuous infusion, began to 50 ~ 60 μg. Kg-1.min-1, until the catheter into the femoral artery or femoral vein, the concentration was reduced to 30gkg-1.min -1. The heart rate, mean arterial pressure, oxygen saturation, respiratory rate and minute ventilation were measured before surgery, 2 minutes after injection, 5 minutes after operation, and the most intense intraoperative stimulation. Observed after anesthesia lobe lobular response; observed after the call response and fully awake time. Results: There was no significant difference in heart rate, blood pressure, respiratory rate and ventilation per minute between propofol target-controlled infusion group and before anesthesia. Postoperative observation of the ear lobe reaction, arousal reaction and complete awake time were significantly less than ketamine continuous infusion group. CONCLUSIONS: Propofol target-controlled infusion is stable during anesthesia in pediatric cardiac catheterization and postoperative recovery is stable. Pediatric cardiac catheterization can be safely applied.