丙泊酚复合小剂量氯胺酮用于小儿眼科手术的临床研究

目的：探讨丙泊酚复合小剂量氯胺酮在小儿眼科手术中的应用价值。方法选取66例ASA I~II级择期实施小儿眼科手术的病人，随机分成研究组（33例）和对照组（33例），研究组运用丙泊酚复合小剂量氯胺酮进行麻醉，对照组采用氯胺酮进行麻醉。比较两组患者各个时间点的心率、平均动脉压、眼内压。药物停止以后分别记录两组患者的完全清醒时间以及评估术后恶心、呕吐等方面的情况。结果对照组患者在气管插管时、手术开始时、术中第15 min及手术结束时的心率、平均动脉压与麻醉前相比均有增快和升高（P＜0.05）。两组患者的相应各时点参数相比较均有极显著性差异（P＜0.05）；对照组患者气管插管时、手术开始时的眼内压跟麻醉前相比均有升高（P＜0.05），两组相应时点的眼内压相比较均有显著差异（P＜0.05）。研究组的恶性呕吐发生率明显低于对照组（P＜O.05），清醒时间也明显短于对照组（P＜;0.05）。结论丙泊酚复合小剂量氯胺酮用于小儿眼科手术的应用价值比较高，围术期的血流动力学稳定性好，术后恶心呕吐发生率低。

Effects of propofol combined with small dose of ketamine used in pediatric ophthalmology surgery

Objective To explore the application of propofol combined with small dose of ketamine in the pediatric ophthalmology surgery. Methods 66 patients with ASA were I~II undergoing pediatric ophthalmology surgery, randomly divided into study group （33 cases） and control group （33 cases）. The study group using propofol combined with small dose of ketamine anesthesia, the control group using ketamine anesthesia. The two groups were compared each time point of the heart rate, mean arterial pressure, intraocular pressure. Stop after the drugs were recorded awake time of two groups of patients and to evaluate the postoperative nausea, vomiting and other aspects of the situation. Re-sults In the control group over fifteenth min and operation starting time with tracheal intubation, intraoperative, heart rate, mean arterial pressure were increased （P〈0.05）. The corresponding point parameters of two groups were signifi-cant different （P〈0.05）; start control group patients during tracheal intubation, operation of intraocular pressure were increased compared with pre anesthesia （P〈0 05）;corresponding point of intraocular pressure phase between two groups were significantly different （P〈0.05）. Nausea and vomiting in study group was significantly lower than the control group （P〈0.05）, sober up time was shorter than that of control group （P〈;0.05）. Conclusions Propofol combined with small dose ketamine is suitable for pediatric ophthalmology surgery. stability of hemodynamics is good in perioperative and the incidence of nausea and vomiting in postoperative is low.