预注咪唑安定氯胺酮在小儿麻醉中的临床使用

Premedication intramuscularly of compounds of midazolam and ketamine in children

目的 :观察预注咪唑安定、氯胺酮对小儿呼吸、循环的生理影响和麻醉维持用药的作用。方法 :随机选择ASAⅠ～Ⅱ级择期手术患儿 4 0例 ,分为 2组 :实验组 :入室前 ,肌注咪唑安定 0 .2mg/kg+氯胺酮 5mg/kg ;对照组 :入室前传统肌注单一氯胺酮 5mg/kg。术中麻醉维持均采用局部神经阻滞复合静脉平衡麻醉。评估患儿静脉穿刺、局部神经阻滞时行为的表现 ,监测患儿入室时HR、RR、SpO2等基本生命征。并记录首次静脉追加用药时间和药物总量及用药持续时间。结果 :实验组患儿静脉穿刺、局部神经阻滞时行为表现评分明显优于对照组 ,静脉追加用药时间则明显迟于对照组 ,单位时间剂量亦明显低于对照组 ;两组患儿术中生命征平稳 ,无显著差异。结论 :预注咪唑安定、氯胺酮用于小儿基础麻醉 ,具有诱导平稳、麻醉效用强并可减少术中静脉用药等优点 ,临床上可安全使用。

Objective: To observe the clinical use of compounds of midazolam and ketamine given intramuscularly as premedication in children. Method: Forty ASA Ⅰ～Ⅱ pediatric patients undergoing elective surgery were randomly divided into two groups: experiment group received compounds of midazolam (0.2mg/kg) and ketamine (5mg/kg) intramuscularly before anesthesia; control group received only ketamine (5mg/kg) intramuscularly. HR, RR and SpO 2 were monitored and recorded before the additive drug was given intravenously. Behavior of children during venous puncture and local anesthesia were graded and assessed. The onset time of additive drug intravenously and total intravenous dosage per hour were recorded. Result: Behavior of children during venous puncture and local anesthesia in experiment group were better than that in control group significantly (P<0.05); The total intravenous additive dosage per hour were lower in experiment group significantly and the onset time were delayed significantly compared with control group. Conclusion: Premedication of compounds of midazolam and ketamine intramus cularly has such advantages as stable induction, high efficacy and lower intravenous anesthetic dosage and it can be used safely.