长托宁与力月西在小儿氯胺酮麻醉前用药的临床分析

目的:探讨长托宁(盐酸戊乙奎醚)力月西(复合咪达唑仑)作为麻醉前用药,在小儿氯胺酮麻醉中对血压、心率的影响及镇静程度和麻醉苏醒期的精神反应情况.方法:56例ASA Ⅰ-Ⅱ级5～10岁患儿随机分为长托宁组和阿托品组,每组28例,均行氯胺酮静脉麻醉.记录各时点的MAP、HR、SpO<,2>,观察患儿用长托宁或阿托品复合力月西后的镇静程度和苏醒期的精神反应情况.结果:两组病例用药后的镇静程度及麻醉苏醒期的精神反应情况比较差异无显著性(P>0.05).HR、MAP与基础值比较,阿托品组用药后HR明显增快,MAP升高(P<0.05);长托宁组HR、MAP基本不变.氯胺酮麻醉后,阿托品组HR显著增快,MAP显著升高(P<0.01),长托宁组HR、MAP略有上升,但差异无显著性(P>0.05),其中HR未超过基础值.结论:长托宁或阿托品复合力月西作为小儿氯胺酮麻醉前用药,均可产生良好的镇静作用,减少麻醉苏醒期的精神反应,但长托宁可使患儿HR、MAP保持稳定,较阿托品更适合作为小儿氯胺酮麻醉的麻醉前用药.

Clinical analysis of changtuoning and midazolam in medication before child ketamine anesthesia

Objective：To investigate the effect of changtuoning（penehyclidine hydrochloride） and midazolam（compound midazolam） as the preanesthetic medication on blood pressure and heart rate in child ketamine anesthesia and their sedative degree and psychic reaction during analepsia period.Methods：56 children patients of 5-10-year-old with ASA I-II level were randomly divided into changtuoning group and atropin group,28 cases in each group,and performed intravenous ketamine anesthesia.To record MAP,HR,SpO2 at different time points.Then,the sedative degree and psychic reaction during analepsia period were observed.Results：The difference of the sedative degree and psychic reaction during analepsia period was not significant between the two groups（P0.05）.Compared with the basic values of HR and MAP,HR of the atropine group was obviously increased,MAP was elevated（（P0.05）.HR and MAP were basically unchanged in the chantuoning group.After ketamine anesthesia,HR in the atropine group was markedly increased,MAP obviously elevated（P〈0.01）.HR and MAP were slightly increased in the changtuoning group without significant difference（P〉0.05）.Among them,HR did not exceed the basic value.Conclusion：Changtuoning or atropin combined with midazolam can be used as preanesthetic medication,which possess better sedative effect,reduce the psychic reaction during analepsia period.Chantuoning could maintain the stability of HR and MAP in the children patients,which better suits the preanesthetic medication in child ketamine anesthesia as compared with atropin.