骶管麻醉复合丙泊酚氯胺酮用于小儿腹部以下手术的临床观察

Clinical study of sacral anesthesia aided ketamine combined with propofol

目的:对比观察骶管麻醉辅助丙泊酚复合氯胺酮和常规丙泊酚氯胺酮静脉全麻用于大于3个月小于6岁患儿腹部以下部位手术的临床效果。方法:100例大于3个月小于6岁进行腹部以下部位择期手术的患儿按麻醉方法的不同随机分为常规麻醉组(氯胺酮丙泊酚组,N组)和骶管麻醉辅助丙泊酚复合氯胺酮组(M组),观察麻醉前后收缩压(SBP)、舒张压(DB)、心率(HR)、呼吸频率(R)、脉搏氧饱和度(SpO2)的变化程度以及术后清醒时间,术中及术后躁动、呕吐等不良反应的发生率。结果:N组与麻醉前相比SBP和DB、心率(HR)显著增高(P<0.01),呼吸频率(R)显著增快,而M组与麻醉前相比差异无显著性。与N组相比,M组术后清醒时间短,术中及术后躁动、呕吐等不良反应发生少(P<0.01)。结论:骶管麻醉辅助丙泊酚复合氯胺酮用于小儿腹部以下部位手术效果满意,呼吸循环更稳定,术后清醒快,其临床效果优于常规丙泊酚氯胺酮静脉全麻。

Objective： To compare the clinical effects of sacral anesthesia aided ketamine combined with propofol and conventional anesthesia （ketamine combined with propefol） in pediatric patients who undergoing operations below belly. Methods： One hundred pediatric patients （ 〈 6 years and 〉 3 monthes） who undergoing elective operations below belly were randomly allocated to either a conventional anesthesia group （ ketamine combined w/th prepofol, group N, n = 50） or sacral anesthesia aided ketamine combined with propofol （ group M, n = 50） . The variation of peri -anesthesia blood pressure （SBP and DB）, heart rate （HR）, respiration rate （RR）, pulse oxygen saturation （ SpO2 ） were tested and recorded. The wake time, the peri - operative incidence of restlessness and vomit were observed. Results： The pest - anesthesia SBP and DBP （ P 〈 0. 01 ）, HR （ P 〈 0. 01 ）, RR （ P 〈 0. 05 ） in group N were significantly increased than its pre - anesthesia level and those in group M. While there were no significant difference of above parameters in group M than its pre - anesthesia level. The wake time, peri - operative incidence of restlessness and vomit in group M were remarkably shorter or lower than those in group N （ P 〈 0. 01 ） . Conclusion： With stable respiration and circulation maintenance, shorter wake time, peri - operative incidence of restlessness and vomit in group M has clinical effect than those in group N.