小剂量氯胺酮全身麻醉在儿科应用的护理研究

A study on nursing care of application of general anesthesia with low dose of ketamine for infants in pediatric department

[目的]探讨氯胺酮全身麻醉在儿科应用疗效及护理。[方法]将2005年6月-2008年6月儿科对需行各种穿刺和活检手术的患儿共160例，按年龄分成3组，常规单用氯胺酮全身麻醉观察疗效3组。[结果]3组患儿麻醉起效时间和持续时间差异无统计学意义（P〉0．05）。用药前后对呼吸（R）、脉搏（P）、血压（BP）的观察仅0岁～3岁组舒张压有统计学意义（P〈0．01），但临床表现无异常。药物副反应：无呼吸抑制，仅有12例呕吐，1例出现幻觉但清醒后消失。[结论]氯胺酮适用于提高儿科小手术的穿刺成功率，安全、有效、副反应少；可消除患儿恐惧感，减少痛苦，缩短住院时间，提高护理质量，构建和谐的护患关系。

Objective： To probe into the curative effect and nursing care of application of general anesthesia with low dose of ketamine for infants in pediatric department. Methods： A total of 160 children accepting all kinds of puncturing or biopsy in pediatric department from June in 2005 to June in 2008 were divided into three groups based on different ages, and only using ketamine for general anesthesia. Then curative effects of them had been ob- served and statistical analysis had been performed. Results： There was no statistical significant difference in terms of onset time and lasting time of anesthesia among three groups （P〉0. 05）. There was statistical significant difference only in diastolic pressure in 0-3 year - old group between before and after medication （P〈0.01）. However, clinical manifestation of them were normal and without adverse reactions of medicine. There was no respir- atory depression among them. Only 12 cases developed vomiting and one case had developed hallucination but disappeared after waking up. Conclusion： Ketamine is suited for enhancing achievement rate of puncturing for pediatric patients accepting small operation. And it is safe, effective and with less adverse reactions. Yet it can relieve fear and pain for children, shorten their length of hospital stay, enhance nursing quality and construct a harmo- nious nurse- patient relationship.