亚麻醉剂量氯胺酮-芬太尼辅助小儿区域麻醉临床效果观察

目的：研究亚麻醉剂量氯胺酮-芬太尼辅助小儿区域麻醉临床效果。方法：选取2009年3月-2012年3月本院接诊的130例进行手术治疗的患儿作为研究对象，按照随机数字表法将其分为试验组和对照组各65例。对照组采用氯胺酮对患儿进行麻醉，试验组采用亚麻醉剂量氯胺酮联合芬太尼对患儿进行麻醉。分别在术前、术后对两组患儿的苏醒时间、胺碘酮用量、呼吸不畅、躁动及精神异常的发生率进行记录分析，并对两组患儿的各项生理指标进行比较。结果：试验组患儿的苏醒时间明显短于对照组，氯胺酮用量明显少于对照组，比较差异均有统计学意义（P〈0.001）；试验组患儿呼吸不畅、躁动及精神异常的发生率均明显低于对照组，比较差异均有统计学意义（P〈0.01）。对两组患儿手术前后的各项生理指标进行比较分析，发现试验组患儿的心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2）的变化幅度均明显低于对照组，比较差异均有统计学意义（P〈0.05）。结论：采用亚麻醉剂量氯胺酮联合芬太尼进行辅助小儿区域麻醉临床效果良好，优于单独使用氯胺酮对患儿进行麻醉，值得临床推广应用。

The Clinical Effect of a Sub-anesthetic Dose of Ketamine-Fentanyl on Children Regional Anesthesia

Objective：To study clinical effect of a sub-anesthetic dose of ketamine-fentanyl on children regional anesthesia.Method：130 children which accepted surgical treatment from March 2009 to March 2012 in our hospital were selected.They were randomly divided into the experimental group and the control group,65 cases in each group.The control group was anesthetized with ketamine on the children,and the experimental group was treated with combined with sub-anesthetic doses of fentanyl on ketamine anesthesia in children.Respectively before and after operation,the two groups of children with recovery time,dosage of amiodarone,shortness of breath,agitation and mental abnormality recording rate were analyzed,and various physiological indexes of two groups of children were compared.Result：The recovery time of the experimental group was significantly shorter than the control group,the amount of ketamine significantly was less than the control group,the differences were statistically significant（P〈0.001）;And the breath,restlessness and mental disorders of the experimental group were significantly lower than the control group,the differences were statistically significant（P〈0.01）. Various physiological indexes before and after the operation of two groups of children were analyzed and compared,and found that the heart rate（HR）,mean arterial pressure（MAP）,oxygen saturation（SpO2）with variation rate of the experimental group were significantly lower than the control group,the differences were statistically significant（P〈0.05）.Conclusion：The clinical effect of a sub-anesthetic dose of ketamine-fentanyl on children regional anesthesia is good,it is better than the single use of ketamine anesthesia for children,is worthy of clinical application.