不同麻醉方式在小儿腹股沟区小手术中的应用比较

目的比较丙泊酚咪达唑仑联合骶管阻滞和氯胺酮复合丙泊酚咪达唑仑在小儿腹股沟区短小手术中应用的有效性和安全性。方法选择小儿(1～6岁)腹股沟区短小手术60例,随机分为A、B两组各30例,A组行丙泊酚咪达唑仑联合骶管阻滞麻醉,B组行氯胺酮复合丙泊酚咪达唑仑麻醉,记录麻醉诱导前T0、诱导后1minT1、切皮时T2、手术开始10minT3、术毕时T4心率(HR)、收缩压(SBP)、舒张压(DBP)、动脉氧饱和度(SpO2),术毕后苏醒时间以及不良反应。结果两组患者呼吸均比较平稳,均能顺利完成手术,但A组循环较B组平稳(P<0.05),苏醒时间短于B组(P<0.05),不良反应发生也低于B组(P<0.05)。结论两种麻醉方式均能安全有效应用于小儿腹股沟区小手术,相对而言,丙泊酚咪达唑仑联合骶管阻滞比氯胺酮复合丙泊酚咪达唑仑术中循环更平稳,苏醒时间更短,不良反应更少见。

The different applications of different anesthesia ways in small operations of pediatric inguinal region

Objective To compare the efficacy and safety of pediatric inguinal region surgery with sacral canal re- tardant using propofol mixed with midazolam and ketamine mixed with Midazolam. Methods 60 cases of children among 1 -- 6 years old, who needed to undertake the pediatric inguinal region surgery, were randomly divided into two groups, 30 cases each group. Group A： the patients anesthetized by propofol mixed with midazolam; group B： the patients anes- thetized by ketamine mixed with Midazolam. Heart rate （HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, pulse oxygen saturation （SpO2） were recorded before anesthesia （T0）, at 1 min after induction （T1）, when cut- ting skin （T2）, at 10 rain after operation（T3 ）, after operation （T4）. And revival time and the adverse reactions after the operation were also recorded. Results Children were breathing smoothly during the operation in both groups, and all op- erations were finished. Circulation in group A was more stable than group B （P〈0. 05）, the revival time was shorter than group B （P〈0. 05）, and adverse reaction was lower than group B （P〈0.05）. Conclusion Two group of anesthesia way were safe and effective using in pediatric inguinal region surgery. More stable circulation, shorter revival time and lower adverse reactions are in sacral canal retardant using propofol mixed with midazolam, rather than ketamine mixed with Midazolam.