丙泊酚合用氯胺酮在小儿腹部以下手术麻醉中的疗效观察

目的探讨丙泊酚单独使用及与氯胺酮合用在小儿椎管内麻醉中的疗效。方法选取我科40名腹部以下手术的患儿，随机分为两组（Ⅰ组和Ⅱ组），分别以单独使用丙泊酚及联合氯胺酮给药的方式，记录术中生命体征及不良事件情况。术后记录恶心、呕吐等不适及疼痛评分。结果两组术中均无呼吸暂停等严重事件发生。手术开始及手术开始后各时段Ⅰ组的生命体征均有显著差异（P（0．05），Ⅱ组手术开始时的收缩压与手术前有显著差异（P〈0．05）。两组术后恢复时间与不适发生无显著差异（P〉0．05），Ⅱ组术后镇痛效果优于Ⅰ组（P〈0．05）。结论丙泊酚合用氯胺酮能够提供更平稳的镇静效果，减轻不良反应的发生，同时不影响苏醒时间，术后不良反应及疼痛发生率较低，是一种理想的小儿椎管内麻醉方法。

Clinical observation of propofol combined with ketamine in the anesthesia of pediatric lower abdominal surgery

Objective To explore the curative effects of propofol and propofol combined with ketamine for intrathecal anesthesia on children. Methods 40 children undergoing spinal anesthesia for lower abdominal surgeries were included and randomly divided into two groups（ Ⅰ , Ⅱ ）. One group received propofol and the other group received combination of propofol and ketamine. The vital signs and adverse events were recorded during the surgery. The occurrence percentage of uncomfortable feeling and pain score were recorded after surgery. Results Serious incident were not observed in all children during the surgery. The vital signs of group I were significantly different at the beginning point of surgery and time points during the surgery（P〈 0.05 ）. While only systolic blood pressure was different before and after the beginning of surgery（P〈0.05）. The recovery time and occurrence percentage of uncomfortable feeling after surgery were no significant differences（P〉0.05）. And children in group Ⅱ performed less pain feeling （P〈0.05）. Conclusion Propofol-ketamine combination provided better quality of sedation with lesser complications than propofol alone and thus can be a good option for sedation during spinal anesthesia in children.