低龄小儿麻醉方式选择的临床分析

Clinical analysis of anesthesia choice in young children

目的探讨低龄小儿手术过程中麻醉方式的选择。方法选择本院收治的60例低龄小儿手术患者为研究对象,分为观察组和对照组。对照组行单纯氯胺酮基础麻醉,观察组采用氯胺酮基础麻醉复合区域神经阻滞麻醉。观察两组患者麻醉前、切皮时、缝皮以及清醒时等不同时刻的SpO2、RR、HR及MAP,并记录镇静评分进行比较。结果观察组患者在T2、T3及T4时刻4项血气指标与T1时刻比较,差异无统计学意义(P>0.05);对照组患者T2、T3及T4时刻的SpO2、RR均明显低于T1时刻(P<0.05),HR及MAP于T2时刻上升,T3时刻下降,与T1时刻比较,差异均有统计学意义(P<0.05),T4时刻时恢复正常,与T1时刻比较差异无统计学意义(P>0.05)。两组患者的4项血气指标在T1时刻差异无统计学意义(P>0.05);观察组患者T2、T3以及T4时刻的SpO2、RR指标均明显高于对照组,T2、T3时刻的HR及MAP明显低于对照组,差异有统计学意义(P<0.05)。观察组患者的不良反应发生率为16.67%,明显高于对照组43.33%,麻醉药物的用量为(2.3±0.4)ml,低于对照组的(8.4±2.7)ml,苏醒所用时间比对照组短,差异有统计学意义(P<0.05)。结论氯胺酮基础麻醉复合区域神经阻滞麻醉既可以满足相应的手术麻醉需要,又可以减少麻醉药物的用量,降低不良反应发生率,确保患儿呼吸顺畅,提高手术麻醉的安全性,效果显著,更适合在低龄小儿手术中使用,值得临床推广。

Objective To explore the young children anesthesia choice in the process of operation. Methods 60 young children with surgerytreated in our hospital were selected as the research objects and divided into the observation group and control group.The control group was given ketamine basic anesthesia alone,the observation group was given ketamine basic anesthesia combined with regional nerve block anesthesia,the SpO2,RR,HR and MAP before anesthesia, when cutting leather,sewing leather and awake at various points in two groups were observed,the sedation scores were recorded and compared. Results Four blood gas index in observation group at T2,T3,and T4 compared with T1,there was no statistically significant difference （P〉0.05）.The SpO2、RR in control group at T2,T3 and T4 were significantly lower than those of the T1 （P〈0.05）,HR and MAP in T2 were increased,T3 were decreased,compared with the T1,the differences were statistically significant （P〈0.05）,T4 returned to normal,there was no statistically significant difference compared with T1 （P〉0.05）. Four blood gas index in two groups ai T1 were compared,there was no statistically significant difference （P〉0.05）.The SpO2、RR in observation group at T2,T3 and T4 were significantly higher than those of the control group,the HR and MAP at T2,T3 were significantly lower than those of the control group,the differences were statistically significant （P〈0.05）.The incidence of adverse reactions in observation group was 16.67%,significantly higher than the control group （43.33%）,the dosage of anesthetic for （2.3±0.4） ml were lower than the control group of （8.4±2.7） ml,the wake up the time was shorter than that of the control group,the difference was statistically significant （P〈0.05）. Conclusion Basis of ketamine anesthesia compound regional nerve block anesthesia can meet the needs of the corresponding anesthesia,and can reduce the dosage of anesthetic drugs,reduce the incidence of adverse reactions,and ensure that patients breathe easier,enhance the security of anesthesia,the effect is remarkable,more suitable for use in young children’s surgery,it is worth clinical promotion.