地佐辛对小儿手术中骶管阻滞复合氯胺酮麻醉效果的影响

Effects of Dezocine on Sacral block Combined with Ketamine Anesthesia in Children

目的观察地佐辛对骶管阻滞复合氯胺酮麻醉用于小儿脐以下手术的效果和安全性。方法随机选择接受脐以下手术的患儿60例,分成D组和C组,每组30例,开通静脉后给予静脉注射氯胺酮2mg/kg,入睡后给予骶管阻滞1%利多卡因1ml/kg,手术切皮前D组给予静脉注射地佐辛0.1mg/kg,C组不给任何镇痛药。记录两组氯胺酮用量、手术时间、清醒时间、术中呼吸抑制、喉痉挛、体动及苏醒期躁动发生率的情况。记录手术前、切皮时、手术结束时的平均动脉压(MBP)、心率(HR)、呼吸频率(RR)、脉搏血氧饱和度(SpO2)等。结果 D组的氯胺酮用量少于C组,清醒时间、苏醒期躁动的发生率明显低于C组,差异有统计学意义(P<0.05)。结论骶管阻滞复合氯胺酮麻醉后单次给予静脉注射地佐辛0.1mg/kg,可以增强骶管阻滞的效果,减少术中追加氯胺酮的用量,苏醒期躁动的发生率明显降低。

Objective To investigate the effects of dezocine on sacral block combined with ketamine anesthesia in children.Methods Sixty ASA Ⅰ patients were randomly divided into two groups with thirty patients in each group.Patients in group D were gived dezocine 0.1mg/kg at pre-operation,and in group C were gived no analgesics.The mean blood pressure （MBP）,heart rate （HR）,respiratory rate （RR） and Pulse Oxygen Saturation （SpO2） were measured on the following time points：before operation（basis）,skin incision and immediatedly after operation.The dosage of ketamine,recovery time and emergence agitation were recorded.Results The dosage of ketamine was lower,emergence agitation was still less and recovery time was significantly shorter in group D than those in group C （P ＜ 0.05）.Conclusion Dizocine of 0.1mg/kg injected intravascularly can enhance the effect of sacral anesthesia and decrease the dose of ketamine with less side effects.