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目的研究异丙酚和氯胺酮麻醉在头面部手术中对血流动力学的影响和术后清醒度的比较。方法５０例病人，ＡＳＡ分级为Ⅰ－Ⅱ，随机分为两组，异丙酚麻醉组（Ｄ），氯胺酮麻醉组（Ｋ）。Ｄ组用异丙酚２．５ｍｇ．ｋｇ－１诱导，用Ｇｒａｅｓｂｙ－３４０泵注异丙酚４．５ｍｇ·ｋｇ－１·ｈ－１维持麻醉；ｋ组用氯胺酮２．０ｍｇ／ｋｇ－１诱导，静脉点滴氯胺酮３ｍｇ·ｋｇ－１·ｈ－１维持麻醉。观察麻醉前（Ｔ０）、注药后（Ｔ１）、插管后（Ｔ２）、手术时（Ｔ３）、拔管前（Ｔ４）５个时点的ＨＲ、ＢＰ的变化，同时观察术后病人清醒的情况，并比较组内的变化和组间的变化。结果两组均对血流动力学有影响，Ｋ组在注药后、插管后、拔管前血压明显升高、心率加快；而Ｄ组在相对时点的ＨＲ、ＢＰ变化比Ｋ组较轻。同时，Ｄ组术后比Ｋ组清醒明显快。结论异丙酚静脉麻醉在头面部肿瘤手术中比氯安酮麻醉更为安全。
Objective To investigate the effect of propofol and ketamine anesthesia on hemodynamics and postoperative awakeness in head and face surgery. Methods 50 patients with ASA grade I-II were randomly divided into two groups: propofol anesthesia group (D) and ketamine anesthesia group (K). Group D used propofol 2.5 mg. Induced by kg-1, anesthesia was maintained with Graesby-340 pump injection of propofol 4.5 mg·kg-1·h-1; k group was induced with ketamine 2.0 mg/kg-1, and intravenous ketamine 3 mg·kg-1· H-1 maintains anesthesia. Observe the change of HR and BP before the anesthesia (T0), postinjection (T1), postintubation (T2), surgery (T3), and extubation (T4), and observe the patient’s awake And compare the changes within the group and the changes between the groups. Results The hemodynamics were affected in both groups. Blood pressure and heart rate increased significantly after injection, before intubation, and before extubation in group K. Compared with group K, the changes of HR and BP in group D at relative time point were higher than those in group K. light. At the same time, the D group was significantly faster than the K group. Conclusion Intravenous propofol anesthesia is safer than chloramphenicol in head and face tumor surgery.