不同剂量氯胺酮麻醉诱导用于小儿腺样体肥大手术的临床效果观察

Clinical effect observation of different dosage of ketamine for induction of anesthesia on the operation of adenoidal hypertrophy

目的 比较不同剂最氯胺酮麻醉诱导用于小儿腺样体肥大手术的临床效果.方法 将80例3～12岁的患儿随机分为A组（氯胺酮诱导剂量为2 mg/kg）与B组（氯胺酮诱导剂量为1 mg/kg）.麻醉诱导时,A组氯胺酮2 mg/kg静脉注射复合丙泊酚与维库溴铵,B组氯胺酮1 mg/kg静脉注射复合丙泊酚与维库溴铵,两组麻醉维持均用丙泊酚与瑞芬太尼.术中根据循环反应和体动情况调整丙泊酚和瑞芬太尼的输注速度.记录术中的循环变化、术后麻醉恢复情况和疼痛情况.结果 与A组比较,B组术中平均动脉压（MAP）变化不明显（P＞0.05）,睁眼时间、拔管时间和定向力恢复时间缩短（P＜0.01）,两组术后6h视觉模拟评分（VAS）差异无统计学意义（P＞0.05）.结论 与2 mg/kg剂量氯胺酮麻醉诱导比较,1 mg/kg剂量氯胺酮麻醉术后清醒更迅速,术中循环稳定及术后早期疼痛无明显差异.

Objective To observe the clinical effect of different dosage of ketamine for induction of anesthesia on the operation of adenoidal hypertrophy.Methods 80 cases of children patients aged from 3 to 12 years old were randomly divided into group A （dosage of ketamine for induction of anesthesia,2 mg/kg） and group B （dosage of ketamine for induction of anesthesia,1 mg/kg）.For inducing of anesthesia,group A was given ketamine （2 mk/kg） with propofol and vecuronium,group B was given ketamine （1 mk/kg） with propofol and vecuronium,the two groups were both used propo- fol and remifentanil.The infusion speed of propofol and vecuronium was adjusted according to circular response and body movement during operation.The changes of circulation during operation,the situation of recovery from anesthesia and pain after surgery was recorded.Results Compared to group A,there was no significant changes of MAP during operation in group B （P〉0.05）.The eye open time,the extubation time and the orientation recovery time was all shortened （P〈0.01）.There was no significant difference of visual analogue scale （VAS） at 6 h after surgery between the two groups （P〉0.OS）.Conclusion Compared to 2 mg/kg dosage of ketamine for induction of anesthesia, the postoperative awake is more quickly of 1 mg/kg dosage of ketamine for induction of anesthesia,while there is no significant difference of circular stability during operation and early pain after surgery.