氯胺酮复合丙泊酚辅助小儿骶管麻醉的临床观察.docxVIP

氯胺酮复合丙泊酚辅助小儿散管麻 醉的临床观察 【摘要】目的对比观察氯胺酮复合丙 泊酚辅助甑管麻醉和常规氯胺酮麻醉用于 小于6岁患儿腹部以下部位手术的临床效果。 方法60例小于6岁进行腹部以下部位择期 手术的患儿按麻醉方法的不同随机分为常 规麻醉组和氯胺酮复合丙泊酚辅助龈管麻 醉组，观察麻醉前后平均动脉压、心率、呼 吸频率、脉搏氧饱和度的变化程度以及术后 清醒时间，术中及术后躁动、呕吐等不良反 应的发生率。结果K组与麻醉前及KPS组麻 醉后相比平均动脉压、心率显着增高，呼吸 频率显着增快，而KPS组与麻醉前相比差异 无显着性。与K组相比，KPS组术后清醒时 间短，术中及术后躁动、呕吐等不良反应发 生少。结论氯胺酮复合丙泊酚辅助龈管麻 醉用于小儿腹部以下部位手术效果满意， 呼 吸循环更稳定，术后清醒快，其临床效果优 于常规氯胺酮麻醉。 【关键词】 散管内麻醉；丙泊酚；氯胺酮 The Clinical study of ketamine combined with propofol aided sacral anesthesia [Abstract 】 Objective To compare the clinical effects of conventional anesthesia (ketamine) and ketamine combined with propofol aided sacral anesthesia in pediatric patients who undergoing operations below Sixty pediatric patients (6 years) who undergoing elective operations below belly were randomly allocated to either a conventional anesthesia group (ketamine , group K , n=30) or ketamine combined with propofol aided sacral anesthesia (group KPS , n=30). The variation of peri-anesthesia mean arterial pressure(MAP) , heart rate(HR), respiration rate(RR) ， pulse oxygen saturation (SpO2)were tested and recorded. The wake time ， the peri-operative incidence of restlessness and vomit were observed. Results The post-anesthesia MAP(P) , HR (P) , RR (P) in group K were significantly increased than its pre-anesthesia level and those in group KPS. While there were no significant difference of above parameters in group KPS than its pre-anesthesia level. The wake time , peri-operative incidence of restlessness and vomit in group KPSwere remarkably shorter or lower than those in group K (P).Conclusion With stable respiration and circulation maintenance , shorter wake time ， peri-operative incidence of restlessness and vomit in group KPS has better clinical effect than those in group K. 【Key words 】 sacral anesthesia ; propofol ； ketamine 小儿龈管麻醉具有止痛完善，肌松满意的优 点，而小儿又具有不易合作的特点。在龈管 麻醉的操作过程中及术中常需辅助镇静药 或全麻药。本文通过氯胺酮复合丙泊酚辅助 小儿甑管麻醉的临床应用，观察其对循环、 呼吸功能的影响，以及术中及术后不良反应 和清醒时间，并与传统的氯胺酮麻醉进行对 比。 1资料与方法 一般资料 选择AS缶级，6岁以下且择期 腹部以下部位手术患儿 6