氯胺酮复合丙泊酚辅助小儿硬膜外麻醉临床观察

目的观察氯胺酮复合丙泊酚辅助硬膜外麻醉应用于<6岁患儿腹部以下部位手术的临床效果。方法50例<6岁进行腹部以下部位择期手术患儿,随机分为氯胺酮组和氯胺酮复合丙泊酚组,每组25例,观察麻醉前后平均动脉压、心率、呼吸频率、血氧饱和度变化情况,术后清醒时间、术中及术后躁动、呕吐等不良反应的发生率。结果氯胺酮组麻醉后与麻醉前相比平均动脉压、心率明显增高(P<0.01),呼吸频率明显增快(P<0.01),氯胺酮复合丙泊酚组麻醉后与麻醉前相比平均动脉压、心率、呼吸频率差异无显著性(P>0.05),但明显低于氯胺酮组(P<0.05,P<0.01);与氯胺酮组相比,氯胺酮复合丙泊酚组术后清醒时间缩短(P<0.01),术中及术后躁动、呕吐等不良反应发生少(P<0.01)。结论氯胺酮复合丙泊酚辅助硬膜外麻醉用于小儿腹部以下部位手术效果满意,呼吸循环稳定,术后清醒快。

Clinical study of ketamine combined with propofol aided pediatric epidural anesthesia

Objective To observe the clinical effects of ketamine combined with propofol aided epidural anesthesia in pediatric patients(<6 years)who underwent operations below abdomen.Methods Fifty pediatric patients(<6 years) who undergoing selective operations below abdomen were randomly divided into ketamine group(n=25) and ketamine combined with propofol group(n=25).The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),pulse oxygen saturation(SpO2),the wake time,the peri-operative incidence of restlessness and vomit were observed.Results The MAP(P<0.01),HR(P<0.01),R(P<0.05) post-anesthesia in ketamine group were significantly increased than pre-anesthesia.There were no significant difference of above parameters pre-and post-anesthesia in ketamine combined with propofol group,but the MAP,HR and RR were higher in ketamine combined with propofol group than those in ketamine group.The wake time post-operation,peri-operative incidence of restlessness and vomit in ketamine combined with propofol group were remarkably shorter or lower than those in ketamine group(P<0.01).Conclusion The way of using ketamine combined with propofol to aid epidural anesthesia in pediatric patients who undergo operations below abdomen can obtain satisfact effect,stable respiration and circulation maintenance and shorter wake time.