丙泊酚及丙泊酚复合氯胺酮辅助小儿骶管麻醉的临床观察

目的：观察丙泊酚或丙泊酚复合氯胺酮辅助骶管麻醉用于小儿下腹部以下手术的临床效果。方法：60例2～8岁行下腹部以下部位择期手术患儿，按麻醉用药不同随机分为P组（丙泊酚组）和PK组（丙泊酚复合氯胺酮组），2组均辅助骶管麻醉，观察惠儿麻醉前、麻醉后5min、10min心率（HR）、平均动脉压（MAP）、脉搏血氧饱和度（SpO2）、呼吸频率（R）的变化以及术后清醒时间、术后恶心呕吐等不良反应发生情况。结果：（1）2组MAP、HR麻醉前后比较差异有统计学意义（P〈0．05），组间差异无统计学意义（P〉0．05）；（2）2组R、Sp02麻醉前后及组间比较差异无统计学意义（P〉0．05）；（3）术后清醒时间P组明显短于PK组（P〈0．01），术后恶心呕吐等不良反应发生率P组明显低于PK组（P〈0．05）。结论：丙泊酚辅助小儿骶管麻醉用于小儿下腹部以下手术麻醉效果满意，术后清醒迅速，不良反应少，围术期安全性高，其临床效果优于丙泊酚复合氯胺酮。

Clinical Study of Propofol and Propofol Combined with Ketamine in Pediatric Sacral Anesthesia

Objective：To evaluate the efficacy of propofol and propofol combined with ketamine in pediatric sacral anesthesia. Methods： 60 pediatric patients who underwent lower abdominal operation were randomly divided into propofol group and propofol combined with ketamine group. The heart rate（ HR）, mean arterial pressure（ MAP）, pulse oxygen saturation（ SpO2 ） , respiration rate（ RR）, anesthetic wake-up time and the incidence of vomiting were recorded and compared between two groups. Results： The post-anesthesia MAP and HR increased significantly（P 〈0.05） , no significant difference was found between the two group. No significant difference was found about the change of R and SpO2. The anesthetic wake-up time in propofol group were shorter than that in propofol combined with ketamine group, the incidence of vomiting was significant low in propofol group. Conclusion： Propofol is superior to propofol combined with ketamine in pediatric lower abdominal operation with short anesthetic wake-up time and low incidence of vomiting.