儿童眼球穿孔伤咪唑安定滴鼻辅助麻醉临床观察

目的　探讨避免儿童眼球穿孔伤术前恐惧及哭闹不安 ,导致眼压增高和眼内容脱出的麻醉方法。方法　 40例儿童眼球穿孔伤随机分成 2组 :A组经鼻滴咪唑安定 (midazolam) ,3 0分钟后肌注氯氨酮 5mg/kg ;B组直接肌注氯氨酮 5mg/kg。结果　咪唑安定滴鼻组 ,患儿肌注氯胺酮时哭闹发生率为 2 5 %,B组为 95 %,两组之间差异有非常显著意义 (P <0 0 1)。咪唑安定滴鼻 ,还可减少术中氯胺酮用量 ,不影响术中SpO2 、不延长术后苏醒时间。结论　儿童眼球穿孔伤 ,肌注氯氨酮前经鼻滴入咪唑安定 ,镇静效果好 ,患儿哭闹少 ,可有效地减少和避免眼压增高引起的眼内容脱出 ,且可减少术中麻醉用药

Clinical observation of assistant midazolam anesthesia through noses used in children with eyeball perforation

Objective To explore the effective anaesthesia method to avoid the dread,cry and uneasiness which result in the increased eye pressure and the prolapsus of eye viscera before the operation to the children who suffer from eyeball perforation.Methods 40 children who suffered from eyeball perforation were divided into group A and and group B;Group A were drop with midazolam through nose,and then were injected with ketamine 5 mg/kg 30 minutes latter.Group B were injected directly with ketamine 5 mg/kg.Results 25% children cried when they were given midazolam in Group A,and it was 95% in Group B.there was significant difference between Group A and Group B( P <0.01).In addition,dropping midazolam through nose could decrease the used amount of ketamine during the operation.however it neither affected the SpO 2 during the operation.nor delay the revival time from anaesthesia state.Conclusion Dropping midazolam through nose before being injected ketamine hold good calmess effect,and it could decrease or avoid the prolapsus of eye viscera because of the increased eye pressure,it also could decrease the used amount of anaesthesia drug during the operation.