丙泊酚辅助腰-硬联合麻醉在小儿手术的临床应用

The clinical application of propofol combined with propofol aided sacral anesthesia used for pediatric operation

目的：对比观察丙泊酚辅助腰-硬联合麻醉和氯胺酮联合丙泊酚麻醉用于5～11岁患儿下腹部或腹部以下部位手术的临床疗效。方法：选择择期100例（ASAⅠ~Ⅱ级）5～11岁进行下腹部或腹部以下部位手术的患儿,随机分成为对照组（氯胺酮复合丙泊酚麻醉组,KP组）和实验组（丙泊酚辅助腰-硬联合麻醉组,CSEA组）,各50例,观察麻醉前后平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2）的变化以及氯胺酮和丙泊酚总用药量、术后清醒时间、术中及术后不良反应的发生率。结果：KP组与CSEA组MAP、HR、SpO2差异无统计学意义（P〉0.05）。与KP组相比,CSEA组氯胺酮和丙泊酚总用药量少、术后清醒时间短、术中及术后等不良反应发生率低（P〈0.05）。结论：丙泊酚辅助腰-硬联合麻醉用于小儿下腹部或腹部以下部位手术效果满意,呼吸循环稳定、术后清醒快、不良反应的发生率低。

Objective：To compare the clinical effects of propof aided combined spinal-epidural anesthesia and ketamine combined with propofol anesthesia in pediatric patients who undergoing operations below belly. Methods： 100 pediatric patients, aged 5 to 11,with ASA grade Ⅰ-Ⅱ, elective operations below belly were randomly allocated to either a conventional group （ketamine combined with propofol,group KP,n=50） or a experiment group （propofol aided Combined spinalepidural anesthesia, group CSEA,n=50）.The variation of peri-anesthesia Mean arterial pressure（MAP） ,Heart rate（HR）, Pulse oxygen saturation （SpO2） were tested and recorded.The total dosage of propofol and ketamine, the wake time ,the perioperative incidence observed. Results： There were no significant difference of MAP、HR、SpO2 between in group CSEA and in group KP（P0.05）. The wake time,the total dosage of propofol and ketamine, peri-operative incidence in group CSEA were remarkably shorter or lower than those in group PK（P0.05）. Conclusion： With stable respiration and circulation maintenance, shorter wake time,peri-operative incidence in group CSEA has better clinical effect than those in group KP.