咪达唑仑和氯胺酮用于神经外科小儿麻醉前口服用药的临床研究

Curative Effect of Oral Midazolam and Ketamine Premedication Used before Paediatric Neurosurgery

目的比较神经外科手术小儿术前口服咪达唑仑和氯胺酮的镇静抗焦虑作用。方法神经外科择期手术患儿90例,随机分为:P组(术前口服50%葡萄糖组,n=30),M组(术前口服咪达唑仑组,n=30)和MK组(术前口服咪达唑仑和氯胺酮组,n=30)。记录并比较患儿与家长分离时及入手术室后开放静脉时的意识状态分级情况、静脉穿刺前后心率的变化以及术后苏醒时间。结果患儿与家长分离时及静脉穿刺时,术前口服镇静药的M组和MK组患儿的精神状态明显好于P组(P<0.01);而静脉穿刺时,MK组的精神状态优于M组(P<0.05)。结论术前口服咪达唑仑和氯胺酮安全有效,适宜用于小儿患者。

Objective To observe the therapeutic effects of oral midazolam and ketamine premedication used before paediatric neurosurgery.Methods Ninty patients before paediatric neurosurgery were divided randomly.They used 50% glucose（P group）,only midazolam（M group）or midazolam and ketamine（MK group）,respectively.The parameters included sedation score before anaesthesia,reaction to separation with parents and venous puncture,intraoperative hemodynamics and palinesthesia time.Results The heart rate of the children in the P group were higher than in the other two groups significantly（P0.01）.In the two oral sedation drug groups,children became calm and coorperative when they were separated with parents and venous puncture.The MK group was better than the M group significantly when venous puncture（P0.05）.Conclusion Premedication with oral midazolam and ketamine is effective and well accepted by paediatric neurosurgery patients.