【摘要】 目的:观察依托咪酯乳剂用于小儿心内手术的麻醉效果并与异丙酚比较。方法:小儿心内直视手术40例,随机分为两组:依托咪酯乳剂组(E组,n=20)和异丙酚组(P组,n=20)。诱导为:咪唑安定0.1mg/kg+依托咪酯乳剂0.3mg/kg(E组)或异丙酚2mg/kg(P组)+芬太尼10ug/kg+维库溴铵0.1mg/kg。观察两组一般情况;麻醉诱导期间不同时点NBP、HR、SpO2及诱导期不良反应发生情况;并随访术后撤机时间和有关并发症。结果:两组患儿一般情况无差异;麻醉诱导期间不同时点血压、心率以E组平稳;两组诱导期呛咳发生均较少,但P组有4例出现注射部位疼痛而E组未发现注射部位疼痛;术后随访两组撤机时间比较无显著差异;两组均未发现注射部位静脉炎及静脉反应。结论:依托咪酯乳剂可复合用于小儿心脏手术的麻醉诱导,减少呛咳反应,不影响术后呼吸机撤离时间,对血液动力学影响较异丙酚小。更多还原

【Abstract】 Objective To compare the clinical effects of etomidate in lipid emulsion and propofol applied in pe-diatric endocardial surgery during induction of anesthesia. Methods Forty children with congenital heart disease,scheduled for open heart surgery, were randomly divided into two groups with 20 cases each, Etomidate in lipid e-musion (E group, n=20) and Propofol (P group, n=20).The drugs of induction in E group are midazolum 0.1mg/kg,fentanyl 10ug/kg, etomidate 0.3mg/kg and vecuronium 0.1mg/kg, the drugs of induction in P group are midazolum0.1mg/kg, fentanyl 10ug/kg, propofol 2mg/kg and vecuronium0.1mg/kg. SBP, DBP, MBP, HR, SPO2 and side effectsare observed and recorded. Results There was no difference between the two groups. SBP, DBP, MBP, HR beforeand after induction of anesthesia in the P group had significant difference. There were only 4 cases in E group and 3in P group appearing cough, but 4 cases in P group feeling pain. The time of ventilator- off in E group was 256.2±12.78min and in P group 262.3±11.54min. Conclusion Both etomidate in lipid emusion and propofol can be appliedin pediatric endocardial surgery during induction of anesthesia to reduce the side effects, and do not influence thetime ofventilator- off. The influence ofetomidate in lipid emusion on hemodynamics is smaller than that ofpropofol.更多还原