【摘要】 目的观察氯胺酮复合咪达唑仑全凭静脉麻醉在地震创伤清创术中的应用效果。方法因地震创伤急需行清创术的伤员56例,随机分为两组,氯胺酮复合咪达唑仑组(KM组)和氯胺酮组(K组)。KM组依次静脉注射咪达唑仑0.02~0.05mg/kg、氯胺酮1~2mg/kg,K组静脉注射氯胺酮1~2mg/kg,术中据情况追加氯胺酮0.5~1mg/kg。观察记录两组伤员术中平均动脉压(MAP)、心率(HR)、呼吸频率(R)及脉搏血氧饱和度(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K组伤员在麻醉后各观察点MAP及HR均较麻醉前显著升高(P<0.05),而KM组与麻醉前比较差异无统计学意义;两组诱导时间和苏醒时间差异无统计学意义。KM组术中肢体运动、术后恶心、呕吐的发生率明显比K组低(P<0.05)。结论氯胺酮复合咪达唑仑全凭静脉麻醉可为地震创伤清创术提供一种安全、快捷、易于管理的麻醉方法。更多还原

【Abstract】 Objective To observe the clinical effect of ketamine-midazolam intravenous anesthesia in earthquake victims undertaking debridement.Methods Fifty-six earthquake victims treated with debridement were randomly divided into two groups:ketamine-midazolam group(Group KM)and ketamine group(Groups K).Midazolam 0.02～0.05mg/kg and ketamine 1～2mg/kg intravenous injection were used in Group KM.Ketamine 1～2mg/kg intravenous injection were used in Group K.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 and HR in Group K were singificantly increased.No conspicuous difference existed in the induction time and consciousness recovery time between the two groups.Less nausea,vomiting and restlessness happened in Group KM than Group K.Conclusion Ketamine-midazolam intravenous anesthesia is safe,effective and with a low incidence of major adverse effects for earthquake victims undertaking debridement.更多还原