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摘要：
[摘要]：目的：研究右美托咪定-氯胺酮复合麻醉用于日间手术的麻醉效果及安全性。方法：100例日间乳腺手术的患者采用随机数字表法随机均分为右美托咪定-氯胺酮组（D组）和丙泊酚-芬太尼组（P组）。持续监测心率（Heart rate,HR）、无创血压（Noninvasive blood pressure,NIBP）、呼吸频率（Respiratory rate,RR）、脉搏血氧饱和度（Pulse oxygen saturation,SpO2）、呼气末CO2分压（End-tidal carbon dioxide tension,PETCO2）等指标，记录麻醉诱导及定向力恢复时间、不良反应情况。结果：D组患者麻醉前后RR、SpO2、PETCO2无明显变化（P>0.05）。P组患者麻醉后RR（10±3次/分）、SpO2（92.1±5.6%）明显下降（P<0.05），而PETCO2（38±6 mmHg）升高（P<0.05），且其中14例发生呼吸抑制，两组差异显著（P<0.01）。D组血流动力学也较P组更加稳定（P<0.05），但麻醉诱导时间（640±102秒）和定向力恢复时间（804±228秒）长于P组（P<0.01）。结论：右美托咪定-氯胺酮复合用于日间乳腺手术的麻醉效果确切，无明显呼吸抑制，血流动力学稳定，是一种较理想的日间手术麻醉方法。
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Abstract: [Abstract] :Objective:To study the effect and safety of dexmedetomidine-ketamine combined anesthesia in day surgery.Methods:100 patients undergoing day surgery of breast were randomly assigned to 2 groups:dexmedetomidine-ketamine group(group D) and propofol-fentanyl group(group P).For each case,HR,NIBP,RR,SpO2 and PETCO2 were monitored continuously;additional measurements included induction time,orientation recovery time and adverse reactions.Results:There were no significant changes in RR, SpO2 and PETCO2 during anesthesia in group D(P>0.05).Which in group P,RR(10±3 times/min),SpO2(92.1±5.6%) were decreased significantly after anesthesia(P<0.05) and PETCO2(38±6mmHg) was increased(P<0.05).Meanwhile,14 cases were found to have respiratory depression in group P,that showed significant differences between two groups(P<0.05).Also hemodynamics was more stably in group D compared with group P(P<0.05).But the anesthesia induction time(640±102s) and orientation recovery time(804±228s) were longer in group D than those in group P(P<0.01).Conclusion:Dexmedetomidine-ketamine combined anesthesia provides exact effect in day surgery of breast,delivering a stable hemodynamic status without respiratory depression.That is an ideal method of anesthesia in day surgery.
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