地佐辛并咪达唑仑在小儿臂丛阻滞麻醉中的应用

目的 观察地佐辛联合咪达唑仑静脉麻醉用于小儿上肢手术臂从阻滞麻醉的临床效果.方法 选择行上肢手术的患儿70例,将其随机平均分成两组:氯胺酮组(L组):术前予氯胺酮1 ～2 mg·kg-1;地佐辛组(D组):术前予咪达唑仑0.05～0.1 mg.kg-1+地佐辛0.1～0.15 mg·kg-1.患儿入睡后,在神经刺激仪的指导下均用0.375％罗哌卡因2～4 mg.kg-1行臂丛阻滞.观察两组术中镇痛、催眠效果,生命体征变化,小儿苏醒状况以及各种不良反应的发生情况.结果 与L组比较,D组术中血压、心率和呼吸平稳,接近术前基础值,且术中生命体征波动较小,苏醒快,术后的各种不良反应均减轻,差异有统计学意义(P＜ 0.05).结论 地佐辛并咪达唑仑静脉麻醉用于小儿臂丛阻滞,可达到满意的镇痛、催眠效果,且术中生命体征波动较小,苏醒快,不良反应发生率减少.

Dezocine combined with midazolam for brachial plexus block in pediatric patients

Objective To observe the clinical effects of intravenous dezocine plus midazolam in brachial plexus block for upper limb surgery in children. Methods 70 pediatric patients undergoing upper extremity surgery were randomly assigned to receive postoperative ketamine of 1 - 2 mg·kg^-1 （ 35 patients, group L ）, or dezocine of 0.1 - 0.15 mg·kg^-1 plus midazolam of 0.05 - 0.1mg·kg^-1（ 35 patients, group D ）. 0.375% ropivacaine of 2 - 4 mg·kg^-1 was used for brachial plexus block after falling asleep. The analgesic and hypnotic effects, changes in vital signs, wake status, and incidence of adverse reactions were observed. Results As compared with group L, blood pressure, healt rate, and breathing were stable in group D, close to the baselines ; no marked changes in intraoperative vital signs and severe postoperative adverse reactions occurred, with significant statistical difference （ P 〈 0.05 ）. Conclusions Dezocine combined with midazolam for brachial plexus block in children has a satisfactory analgesic and hypnotic effect, with fewer adverse reactions. The pediatric patients have relatively stable vital signs and awake rapidly.