小儿骨科手术麻醉方法与神经阻滞安全性探讨

Discussion on anesthesia methods and security of nerve blocking in pediatric orthopaedic surgery

目的对当前我国小儿骨科手术中，将亚麻醉剂氯氨酮应用在小儿骨科手术中硬膜外麻醉与神经阻滞辅助用药的安全性进行分析和探讨。方法选取本院2008年7月-2012年9月收治的100例患儿，并根据患儿家长的同意，将患者分为观察组和对照组，观察组和对照组各50例，对观察组患儿在进行骨科手术的时候采用亚麻醉剂量氯胺酮辅助给予治疗，对对照组患儿并不采用任何辅助措施，并观察两组患儿在麻醉中的反应。结果治疗结果发现，观察组患儿采用了亚麻醉剂量氯胺酮辅助进行治疗，在麻醉的状态下，患儿告知不适感觉的占8．3％，对照组患儿在麻醉的状态下，告知有不适感觉的占48．0％。两组比较统计学有意义（P〈0．05）。结论在小儿骨科手术中将亚麻醉剂量氯胺酮应用在硬膜外麻醉与神经阻滞中作为辅助治疗用药，可以缓解患儿在手术期间紧张、焦虑的情绪、从而顺利的进行手术，增强患儿在手术中对于不适的耐受力，提高治疗效率。

Objective To analyze and discuss the small-dose ketamine anesthesia in epidural anesthesia and security of adjuvant drugs for nerve blocking in pediatric orthopaedic surgery in China now. Methods 100 children selected in our hospital from July 2008 to September 2012 were divided into the observation group treated by smalldose ketamine anesthesia adjuvant therapy in pediatric orthopaedic surgery and the control group did not take any adjuvant measures according to the consent of children＇s parents,and each group were 50 cases. The anesthesia reaction of children in two groups were observed. Results The treatment results found that children with bad feel under anesthetic in the observation group treated by small-dose ketamine anesthesia adjuvant therapy were 8.3%,while children with bad feel under anesthetic in the control group were 48.0%.The difference between two groups was statistically significant（P 〈 0.05）. Conclusion Small-dose ketamine anesthesia using in epidural anesthesia and being adjuvant drugs for nerve blocking in pediatric orthopaedic surgery can relieve the nervous and anxiety of children during surgery for make the surgery successful, increase the endurance of children for uncomfortableness during surgery, and improve the efficiency of the treatment.