氯胺酮东莨菪碱利多卡因合剂用于小儿唇裂手术的药效观察

The effect of ketamine,scopolamine,lidocaine mixture in surgery on the children with simple cleft lip

目的:评价用氯胺酮0.1g、东莨菪碱0.3mg、2%利多卡因5ml共8ml为一单元(简称KSL合剂)和单纯氯胺酮静脉麻醉对小儿唇裂手术进行用药的比较。方法:随机将唇裂患儿186例分二组。手术开始后二组分别静注KSL合剂(Ⅰ组)和单纯氯胺酮(Ⅱ组)进行麻醉维持,分别观察第二次相距第一次、第三次相距第二次及第四次相距第三次的用药间隔时间,氯胺酮用药的总药量及术后清醒的时间。结果:手术开始后第二次给药相距第一次给药的时间、第三次相距第二次给药时间及第四次相距第三次给药时间,KSL组(Ⅰ组)明显大于对照组(Ⅱ组)(P<0.01)。KSL组(Ⅰ组)氯胺酮的总用量明显小于以对照组(Ⅱ组)(P<0.01)。而KSL组(Ⅰ组)术毕的苏醒时间又明显小于对照组(Ⅱ组)(P<0.01)。结论:小儿单纯唇裂应用KSL合剂比单纯应用氯胺酮麻醉可减少氯胺酮的用药量,术后在较短的时间内即可清醒。

Objective： To compare the use of Ketamine 0. 1 g, scopolamine 0. 3 rag, 2% lidocaine 5 ml in a total of 8 ml as a unit （referred to as KSL mixtre） and pure ketamine intravenous anesthesia in surgery on the children with simple Ⅱ cleft lip. Methods： 186 cases of children with Ⅱ cleft lip were divided into two groups. Surgery after the intravenous injection for the two groups, respectively, KSL mixture （group 1） and Ketamine （group 2） for the maintenance of anesthesia, the time intervals were observed between each injections, also the total drug dosage of ketamine and the time of emerging from anesthesia were recorded. Results： The time interval between the first injection and the second, the second to the third and the third to the fourth, KSL group was significantly greater than the control group. For the KSL group, the total dosage of Ketamine was significantly less than the control group, the surgery emerging time is obviously short than the control group. Conclusion： Compared to pure Ketamine group, application of KSL mixture intravenous anesthesia in simple Ⅱ cleft lip surgery can reduce the dosage of Ketamine and relatively shorter the emergence time.