平衡麻醉用于婴幼儿唇腭裂修复手术的效果观察

目的 观察平衡麻醉用于婴幼儿唇腭裂修复手术的麻醉效果，从中筛选最佳平衡麻醉药物的组合方案。方法 150例拟施唇腭裂修复手术的婴幼儿在同样条件下诱导插管后，随机分为氯胺酮复合异氟烷和维库溴铵维持组（K组，50例），氯胺酮复合丙泊酚、异氟烷和维库溴铵维持组（K＋P组，50例），氯胺酮复合咪达唑仑、异氟烷和维库溴铵维持组（K＋M组，50例）。观察记录麻醉前、气管插管后、手术结束时和气管拔管后的心率、呼吸、呼气末CO2分压和脉搏血氧饱和度的变化，观察并记录术中和苏醒期的并发症，记录苏醒时间。结果 K组在麻醉后各时段的心率明显快于K＋P组和K＋M组（P〈0．01）。K＋P组的苏醒时间明显短于K组和K＋M组（P〈0．01）。K＋P组术后恶心呕吐的发生率明显低于K组和K＋P组（P〈0．01）。K组气管拔管后早期缺氧的发生率较高。结论 氯胺酮复合丙泊酚、异氟烷和维库溴铵用于婴幼儿唇腭裂修复手术的平衡麻醉效果好，心血管功能稳定，苏醒快。术后恶心呕吐等并发症少。

Clinical study of balanced anesthesia on infancy children in cleft lip and palate repairing operation

Objective To observe and study the effects of balanced anesthesia on infancy children in cleft lip and palate repairing operation.Methods 150 infancy children scheduled for cleft lip and palate repairing operation were randomly divided into group ketamine with isoflurane and vencuronium(group K,50 cases),group ketamine with propofol,isoflurane and vencuronium(group K P,50 cases) and group ketamine with midazolam,isoflurane and vencuronium(group K M,50 cases).The HR and RR,P_ ET CO_ 2 and SpO_ 2 were observed and recorded before anesthesia (T_ 1 ) and after operation (T_ 2 ),operation ended(T_ 3 ) and after extubation(T_ 4 ).The side effects during and after operation were observed and recorded. Results The value of HR in group K at T_ 2 ,T_ 3 and T_ 4 were significantly higher than that in group K P,(P< 0.01 ).The waking time in group K P was significantly shorter than that in group K and K M(P< 0.01 ).In group K P, the side effects of mental disorder and vomiting during waking time was significantly lower than that in group K, Conclusion The study suggests that ketamine-propofol with isoflurane and vencuronium on infancy children in cleft and palate repairing operation has a better anesthesia effect and lower side effect.