七氟醚、氯胺酮静吸复合麻醉与氯胺酮静脉麻醉在小儿斜视手术中的应用

Comparison on sevoflurane inhalational anesthesia combined with ketamine intravenous anesthesia and ketamine intravenous anaesthesia in children undertaking strabismus surgery

目的：探讨两种麻醉方法在小儿斜视手术中的应用,并比较优缺点。方法：选择ASAⅠ～Ⅱ级,择期接受斜视手术的患儿32例。随机分为七氟醚、氯胺酮静吸复合麻醉组（A组）和氯胺酮静脉麻醉组（B组）各16例,保留自主呼吸,为保证通气安全,均采用喉罩置入技术。记录摇头、肢体活动和血氧饱合度SpO2〈95%的发生例数、眼心反射（oculocardiac re-flex,OCR）和术后呕吐（postoperati vevomiting,POV）、燥动的发生例数,睫毛反射消失时间、清醒时间等指标。结果：静吸复合麻醉组患儿接受程度高,血氧饱合度维持好,清醒快,OCR,术后燥动发生率低（P〈0.05）,但POV无明显差异（P〉0.05）。结论：在小儿斜视手术中,七氟醚、氯胺酮静吸复合麻醉优于氯胺酮静脉麻醉。

AIM： To investigate the advantages and disadvantages of sevoflurane inhalational anesthesia combined with ketamine intravenous anesthesia and ketamine intravenous anaesthesia undertaking strabismus surgery in children. METHODS.. Thirty-two children （ ASA Ⅰ-Ⅱ grade） undertaking strabismus surgery were randomly divided into sevoflurane inhalational anesthesia combined with ketamine intravenous anesthesia （group A, n = 16） and ketamine intravenous anaesthesia （group B, n = 16）. Laryngealmask airway （LMA） was used to secure respiratory airway. All children breathed spontaneously during operative period. The incidence of SpO2 was less than 95% and the movement of the limbs and head induced by operative stimulation. The revival time, lash reflex extinction time, oculocardiac reflex （ OCR ）, postoperative vomiting （ POV ） and postoperative restlessness were recorded in all children. RESULTS： The degree of reception in group A was higher than that in group B, but incidence of postoperative restlessness and SpO2 were less than 95%, OCR and the revival time in group A were less than those in group B. CONCLUSION： Compared with ketamine intravenous anaesthesia, sevoflurane inhalational anesthesia combined with ketamine intravenous anesthesia has better anesthetic quality. It is a new anesthesia method with more advantages in children undertaking strabismus surgery.