氯胺酮复合异丙酚辅助小儿硬膜外麻醉的临床观察

Clinical study on ketamine combined with propofol applied for pediatric epidural anesthesia

目的观察氯胺酮复合异丙酚辅助硬膜外麻醉在小儿科手术中的临床效果。方法50例3—8岁手术患儿，随机分为两组，每组25例。氯胺酮组（K组）和氯胺酮复合异丙酚组（KP组）。观察麻醉前、后平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2）、呼吸频率（RR）的情况并记录，记录麻醉苏醒时间，术中、术后并发症。结果K组与KP组比：MAP、HR明显升高，呼吸频率明显增快，局麻药用量增加，苏醒时间延长，术中及术后躁动且恶心呕吐等不良反应多。结论氟胺酮复合异丙酚加硬膜外麻醉用于小外科手术效果满意，呼吸循环稳定，术后苏醒快。

Objective To observe the clinical effect of ketamlne combined with propofol in epidural anesthesia in pediatric patients. Methods Fifty pediatric patients were randomly allocated into ketamine group （ n = 25 ） and ketamine combined with propofol group （ n = 25 ）. The mean arterial pressure （MAP）, heart rate （HR）, respiration rate （RR）, plasma oxygen saturation （SpO2 ）, analeptic time and intraoperatire and postoperative complications were observed and recorded. Results The MAP, HR and RR in patients of ketamine group were significantly increased, analeptic time was longer and the intraoperative and postoperative complications were more frequent than those of patients in ketamine combined with propofol group. Conclusion The application of ketamlne combined with prepofol in epidural anesthesia for pediatric patients during operations can obtain satisfactory effect, stable respiration and circulation maintenance and short wakening time.