舒芬太尼复合氯胺酮静脉麻醉用于小儿斜视手术的临床观察

目的 观察不同剂量舒芬太尼复合氯胺酮静脉麻醉在小儿眼科斜视手术中的应用效果。方法择期斜视手术患儿80例随机分为4组，对照组和舒芬太尼A、B、C3组。对照组采用氯胺酮诱导：A组采用舒芬太尼0．05μg／kg＋氯胺酮；B组采用舒芬太尼0．08μg／kg＋氯胺酮；C组采用舒芬太尼0．1μg/kg＋氯胺酮。各组均用氯胺酮维持。记录并比较各组在麻醉前、诱导后、手术开始及术毕时循环功能和呼吸功能变化以及氯胺酮用量、术后苏醒时间和并发症。结果舒芬太尼各组的苏醒时间分别为（2．2±2．3）min、（2．3±3．8）min及（3．2±4．4）min,均显著短于对照组的（17．4±11．3）min（P≤0．001）；离开恢复室时间分别为（4．7±2．7）min、（4．4±3．2）min及（6．5±5．0）min，也均显著短于对照组的（24．7±11．5）min（P≤0．001）；氯胺酮用量舒芬太尼各组分别为（1．78±0．62）mg／kg、（1．35±0．35）mg／kg及（1．48±0．56）mg／kg，亦显著少于对照组的（5．44±1．29）mg／kg。P≤0．001。结论舒芬太尼复合氯胺酮效果优于单用氯胺酮麻醉．

Clinical observation of intravenous anesthesia of sufentanil combined with ketamine in the pediatric strabismus surgeries

Objective To observe the effects of different doses of sufentanil combined with ketamine in the pediatric strabismus surgeries. Methods 80 children were scheduled for strabismus surgery. They were divided into four groups randomly,which included sufentanil groupA,B,C and control group.A group： the patients were given sufentanil 0.05 μg/kg and ketamine; B group：the patients were given sufentanil 0.08μg/kg and ketamine; C group： the patients were given sufentanil 0.01g/kg and ketamine; control group：the patients were given only ketamine.The circulatory and respiratory functions were monitored.The parameters at four points were compared： before anesthesia,after induction,at the beginming and the end of operation.The dosage of ketamine,recovery time and complications were also recorded. Results The recovery time of sufentanil group A,B,C was （2.2±2.3）min, （2.3±3.8）min and （3.2±4.4）min respectively,and was shorter than that of control group （17.4±11.3）min （P〈0.001）;the time stayed in PACU of sufentanil group A,B,C was （4.7± 2.7）min, （4.4±3.2）min and （6.5±5.0）min respectively,and was shorter than that of control group （24.7±11.5）min （P〈 0.01）;The dosage of ketamine in sufentanil group A,B,C was（ 1.78±0.62）mg/kg, （1.35±0.35）mg/kg and （1.48±0.56）mg/kg, and was less than that of control group （5.44±1.29）mg/kg,（P〈0.001）. Conclusions Compared with the usage of ketamine alone, sufentanil combined with ketamine is more effective in pediatric strabismus surgery.