Effects of Remifentanly and Ketamin on Parturient Blood Pressure, Heart Rate and Neonate Apgar Score_West China Medical Journal

Authors：

HE Juying ¹ , CAO Rong ¹ , LI Shouli ¹ , et al ²

1the Department of Anesthesiology, Maternal and Children’s Health Care Hospital of Chengdu, Chengdu 610031; 2the Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

全身麻醉; 剖宫产; 瑞芬太尼; 氯胺酮; Apgar评分

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目的:对照研究在全麻剖宫产术中应用瑞芬太尼和氯胺酮诱导对母婴的影响。方法:选择100例禁忌椎管内麻醉而须行全麻剖宫产手术的患者,分为两组,氯胺酮组静注异丙酚1.5mg/kg+氯胺酮1mg／kg+琥珀胆碱1.5mg／kg;瑞芬太尼组静注异丙酚1.5mg/kg+瑞芬太尼1μg/kg+琥珀胆碱1.5mg／kg诱导插管,胎儿娩出后均静注芬太尼2g／kg、泵注异丙酚3mg/(kg·h)和吸入异氟醚0.5MAC维持麻醉,阿曲库铵维持肌松。结果:瑞芬太尼组插管(切皮)后血压、心率升高幅度显著小于氯胺酮组,两组新生儿1min、5min Apgar评分无明显差异。结论:瑞芬太尼用于产科全麻优于氯胺酮,安全可行。

Citation： HE Juying,CAO Rong,LI Shouli,et al. Effects of Remifentanly and Ketamin on Parturient Blood Pressure, Heart Rate and Neonate Apgar Score. West China Medical Journal, 2009, 24(8): 2114-2116. doi: Copy

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1. GLASS P S, GAN T J, HOWELL S. A review of tphamarmacodynamics of remifentanil[J]． Anesth Analg,1999,89:7-14.
2. 吴新民,叶铁虎,岳云,等.国产注射用盐酸瑞芬太尼有效性和安全性的评价[J].中华麻醉学杂志,2003,23(4):245-２４8.
3. 敖光亮,黄盛辉.小剂量氯胺酮防止剖宫产术中腹膜牵拉反应的临床观察[J].广东医学,1999,20(6):56-57.
4. 庄心良,曾因明,陈伯銮,主编.现代麻醉学[M]．第3版.北京:人民卫生出版社,2003:525.
5. 高秀江,张志辉,毛瑞芬,等.瑞芬太尼与芬太尼对腹部手术患者全麻诱导期血液动力学的影响[J].中华麻醉学杂志,2005,25(2):149-50.
6. 黄悦,杭燕南.小儿瑞芬太尼药动学及临床研究进展[J].国外医学麻醉与复苏分册,2005,26(2):114-117.
7. EGAN T D, LEMMENS H J, FISET P, et al. The pharmacokinetics of the new shortacting opioid remifentanil (GI87084B) in healthy adult male[J]. Anesthesiology,1993,79:881.

West China Medical Journal

Effects of Remifentanly and Ketamin on Parturient Blood Pressure, Heart Rate and Neonate Apgar Score

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