小剂量氯胺酮-丙泊酚加臂丛神经阻滞用于患儿断指再植术中麻醉的临床观察

Clinical observation of low dose ketamine-propofol anesthisia combined with brachial plexus block in children undergoing finger replantation

目的比较小剂量氯胺酮-丙泊酚加臂丛神经阻滞与氯胺酮-丙泊酚静脉麻醉用于患儿断指再植术的麻醉效果与安全性。方法急诊断指再植术患儿80例,随机均分为两组。A组为氯胺酮-丙泊酚加臂丛神经阻滞;B组为氯胺酮-丙泊酚静脉麻醉。记录手术前后心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO2)、呼吸频率(RR)变化,评价麻醉效果以及苏醒期反应。结果术中,B组MAP和HR明显高于A组(P<0.05),B组的SpO2和RR值明显低于A组(P<0.05);A组氯胺酮、丙泊酚用量明显少于B组(P<0.01);术后A组苏醒较快且平稳,苏醒期精神症状少(P<0.01)。结论小剂量氯胺酮-丙泊酚加臂丛神经阻滞应用于患儿断指再植术麻醉效果好,不良反应少。

Objective To observe the efficacy and safety of low dose ketamine-propofol anesthesia combined with brachial plexus block（BPB） in children undergoing finger replantation.Methods Eighty children undergoing finger replantation were randomly divided into two groups with 40 cases each.The patients in group A were given ketamine-propofol combined with BPB and those in group B were given ketamine-propofol intravenous anesthesia alone.The Heart rate（HR）,mean arterial pressure（MAP）,respiratory rate（RR） and pulse oxygen saturation（SpO2） were recorded.The efficacy of anesthesia and adverse effects were evaluated.Results The MAP and HR were significantly higher,but SpO2was lower,in group B than those in group A（P0.05）.The consumption of ketamine and propofol was significantly less in group A than that in group B（P0.01）.The recovery from anesthesia was quiker and smoother in group A than that in group B（P0.01）.Conclusion Low dose ketamine-propofol anesthesia combined with BPB is a good choice for the children undergoing finger replantation surgery.