氯胺酮与异丙酚联合罗哌卡因用于小儿疝麻醉的临床研究

Clinic Investigation of Using Ropivacation Combined with Ketamine and Propofol in Pediatric Hernia Anesthesia

目的研究氯胺酮异丙酚静脉麻醉联合罗哌卡因局部浸润麻醉用于小儿疝手术的效果及其安全性。方法选择2007～2008年浏阳市妇幼保健院收治的，美国麻醉医师协会对病情评估分级Ⅰ～Ⅱ级行腹股沟斜疝疝囊高位结扎术的患儿600例，随机均分成2组：单用氯胺酮麻醉组（K组）和氯胺酮、异丙酚静脉联合罗哌卡因局部浸润麻醉组（C组）。对两组的麻醉效果、对呼吸循环的影响、氯胺酮总用量、母子分离时间、术后苏醒时间、术后哭闹时间、术后疼痛情况、并发症等进行比较。结果两组均能提供满意的麻醉效果。与K组比较，C组对呼吸循环影响轻微，氯胺酮总用量少，母子分离时间、术后苏醒时间、术后哭闹时间短均少于K组，术后疼痛轻，并发症少，差异均有统计学意义（P〈0．05）。结论氯胺酮和异丙酚静脉联合罗哌卡因局部浸润麻醉用于小儿疝手术，麻醉更平稳，苏醒快，术后疼痛轻，并发症少，是一种比较安全有效的麻醉方法。

Objective To investigate the effect of ketamine-propofol intravenous anesthesia combined with ropivacation local infiltration anesthesia and the safety and feasibility in pediatric hernia operation. Methods A total of 600 pediatric patients of indirect inguinal hernia sac high ligation on ASA Ⅰ -Ⅱ level were randomly divided into two groups. Of them, group K was anesthetized only with ketamine and group C was treated with ketamine-prepofol intravenous anesthesia combined with propofol local infiltration anesthesia. Anesthesia effect, effect to respiration and circulation, ketamine total dose, time of mother-son＇s separation,postoperative recovery time,crying-time,pain after operation and complications were compared. Results Compared with group K, group C had the lower effect to respiration and circulation. Group C has some advantages such as less ketamine total dose, shorter time of mother-son＇s separation and postoperative recovering,shorter crying-time and less pain and complication （ P 〈 0.05 ）. Conclusion The anesthesia can he more steady, and patients recover more quickly, have less pains and complications when ketamine-propofol intravenous anesthesia combined with ropivaeation local infiltration anesthesia is applied for the pediatric. It＇s a safe and effective anesthesia method.