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  【摘要】目的：评价异丙酚与瑞芬太尼静脉复合麻醉用于小儿唇腭裂修复术的可行性及优越性。方法：80例1～3岁唇腭裂患儿随机分成两组(n40)；瑞芬太尼复合异丙酚组(R组)和氯胺酮复合异丙酚组(K组)，分别以瑞芬太尼复合异丙酚或氯胺酮复合异丙酚诱导和维持麻醉。观察两组患儿诱导前(T0)、诱导时(T1)、手术即刻(T2)、手术15分钟(T3)、清醒拔管(T4)时血流动力学的变化；记录手术时间、清醒及拔管时间，并观察术后恶心呕吐，呼吸抑制及躁动等不良反应。结果：两组患儿术中血流动力学稳定，R组与K组清晰时间分别为(6.5±2.2)min、(24.9±3.96)min，差异有统计学意义。结论：异丙酚与瑞芬太尼静脉复合麻醉用于小儿唇腭裂修复术优于氯胺酮复合异丙酚麻醉，可以缩短清醒时间、拔管时间及手术室滞留时间，术后并发症少。

 【关键词】瑞芬太尼；氯胺酮；异丙酚；全身静脉麻醉；唇腭裂修复术

 【中图分类号】R782.054【文献标识码】B【文章编号】1008-6455(2011)08-0112-02

 Contradistinctive observation of compound anesthesia for cleft lip and palate repairing operation

 of children between ketamine and remifentanil which is used with propofol

 gao de-sheng

 Gao Demei

 【Abstract】Objective:PurposeEvaluate the feasibility and advantage of propofol and remifentanil which are used to compound anesthesia for cleft lip and palate repairing operation of children.Methods:Separate80 sample of 1 to 3 years old children suffered from cleft lip and palate into two groups randomly (n40); group remifentanil compound with propofol (group R) and ketamine compound with propofol (group K), abduct and maintain with remifentanil compound with propofol and ketamine compound with propofol respectively. Observe the changes of blood stream dynamics of the two groups of children at following time: before abduction (T0), abducting (T1), the very beginning of operation (T2), 15 min after the beginning (T3), pull out the cannulation after they are clear-headed (T4); record the time of operation, the time of waking and pulling out the cannulation, and observe the kickback after the operation such as nausea and vomit, restraint of breath and impetuosity..Results:The blood stream dynamics of two groups was steady during the operation, group R’waking up time is (6.5±2.2)min, the counterpart of group K is (24.9±3.96)min, the difference has meaning in statistics.Conclusion:It is better to use propofol and remifentanil on compound anesthesia for cleft lip and palate repairing operation of children than ketamine and remifentanil, the foregoing one could shorten the time of waking and pulling out the cannulation as well as staying in the surgery, also, syndrome after the operation is less ......