氯胺酮复合骶管麻醉在小儿下腹部手术的应用

目的:观察氯胺酮复合骶管麻醉在小儿下腹部手术的临床疗效及安全性。方法:选择行腹部以下部位择期手术的患儿40例,年龄2~8岁,ASA I~Ⅱ级,随机均分成两组。A组为氯胺酮复合小儿骶管麻醉,B组为单纯氯胺酮麻醉,观察入室时(T1)、手术切皮时(T2)及手术结束后(T3)各时患儿的HR、SpO2及MAP变化,术中氯胺酮用量及苏醒时间,术中及术后躁动、呕吐等不良反应的发生率。结果:A组氯胺酮总用量较B组明显减少(P<0.05),MAP、HR波动小于B组,患儿苏醒较B组快,术中及术后躁动、呕吐等不良反应发生少(P<0.01),B组有4例出现呼吸抑制经正压辅助呼吸后SpO2很快回升95%以上,A组术后护理中小儿的配合较B组好。结论:氯胺酮复合骶管麻醉用于小儿下腹部手术是安全可行的。

Ketamine combined with sacral anesthesia for abdominal surgery in children

Objective To investigate the clinical efficacy and safety of ketamine combined with sacral anesthesia for abdominal surgery in children.MethodForty 2～8 year-old cases(ASA I～II) undergoing abdominal surgery were randomly divided into two groups.Cases in group A received ketamine combined with sacral anesthesia,while those in group B simple ketamine anesthesia.The changes of HR,SpO2 and MAP,the dosage of ketamine,the recovery time and the occurrence rate of restlessness and vomiting were observed in different periods of T1(preoperation),T2(during operation) and T3(postoperation).ResultsThe total dosage of ketamine in group A significantly reduced compared with group B(P<0.05).There were more fluctuation on HR,MAP in group B and the cases were awake slower in group B.The adverse reactions such as restlessness and vomiting occurred less in group A(P<0.01).Four cases with respiratory depression in group B were given barotropic support and SpO2 rebounded to more than 95%.Cases could cooperate better in group A.ConclusionThe method of ketamine combined with sacral anesthesia used for abdominal surgery among children is safe and feasible.