利多卡因-氯胺酮合剂静脉麻醉用于小儿斜视手术的临床观察

Clinical observation of intravenous anesthesia of lidocaine combined with ketamine in the pediatric strabismus surgeries

目的探讨利多卡因-氯胺酮合剂(以下简称利氯合剂)静脉麻醉在小儿眼科斜视手术中的应用效果。方法择期手术患儿60例随机分为3组:氯胺酮肌注+静脉麻醉组(A组)、氯胺酮静脉麻醉组(B组)和利氯合剂静脉麻醉组(C组)。记录并比较各组在麻醉前、诱导后、手术开始及术毕时循环功能和呼吸功能变化以及氯胺酮用量、术后苏醒时间和并发症。结果各组的苏醒时间分别为(24.2±5.8)min、(16.8±4.2)min及(10.3±4.6)min,和A组比较,B、C组的苏醒时间明显缩短(P<0.05);和B组比较,C组的苏醒时间明显缩短(P<0.05)。离开恢复室时间分别(39.7±4.3)min、(24.1±3.6)min及(15.6±3.2)min,和A组比较,B、C组的离开恢复室时间明显减少(P<0.05);和B组比较,C组的离开恢复室时间明显减少(P<0.05)。氯胺酮用量各组分别为(8.44±0.62)mg/kg、(5.48±0.84)mg/kg及(3.52±0.46)mg/kg,C组显著少于A组和B组(P<0.05)。结论在小儿斜视手术麻醉中,利氯合剂静脉麻醉效果优于单用氯胺酮麻醉。

Objective To observe the effects of lidocaine combined with ketamine in the pediatric strabismus surgeries.Methods 60 children were scheduled for strabismus surgery.They were divided into three groups randomly.A group：the patients were given ketamine by muscle and vein;B group：the patients were given ketamine by vein;C group：the patients were given lidocaine combined with ketamine by vein.The circulatory and respiratory functions were monitored.The parameters at four points were compared：before anesthesia,after induction,at the beginming and the end of operation.The dosage of ketamine,recovery time and complications were also recorded.Results The recovery time of groupA,B,C was（24.2±5.8）min,（16.8±4.2）min and（10.3±4.6）min respectively,compared with the group A,it was shorter than that of group B and C（P0.05）;compared with the group B,it was shorter than that of group C（P0.05）.The time stayed in PACU of group A,B,C was（39.7± 4.3）min,（24.1±3.6）min and（15.6±3.2）min respectively,compared with the group A,it was less than that of group B and C（P 0.05）;compared with the group B,it was less than that of group C（P0.05）.The dosage of ketamine in group A,B,C was（8.44± 0.62）mg/kg,（5.48±0.84）mg/kg and（3.52±0.46）mg/kg respectively,compared with the group C,it was less than that of group A and B（P0.05）.Conclusion Compared with the usage of ketamine alone,lidocaine combined with ketamine is more effective in pediatric strabismus surgery.