小儿麻醉舒适化诱导技术的临床应用探索

Clinical application exploration of comfortably inducing technique in pediatric anesthesia

目的：评价咪唑安定在小儿麻醉舒适化诱导技术中的效果。方法60例拟在全麻下行尿道下裂修补术患儿，ASA Ⅰ～Ⅱ级，年龄1.5～4岁，体质量10～20 kg ，随机分为两组。咪达唑仑组（治疗组）诱导前静注咪达唑仑0.08 mg/kg ，氯胺酮组（对照组）诱导前静注氯胺酮1 mg/kg ，两组患儿行静脉穿刺及诱导前给药时均有父母陪伴。对小儿给药前后进行镇静评分，记录小儿入室时心率、动脉血氧饱和度、血压，记录手术后拔管时间、术后有无不良反应及父母满意度。并对手术后患儿进行3个月随访，观察有无噩梦、抑郁等行为障碍。结果和对照组相比，诱导前应用咪达唑仑0.08 mg/kg ，患儿心率、血压更平稳，手术后拔管时间更短，不良反应更少，差异有统计学意义（P＜0.05）。两组患儿术后均未发现行为障碍。结论咪达唑仑0.08 mg/kg用于小儿麻醉舒适化诱导技术，可以提高患儿对医护人员的依从性、麻醉诱导更平稳、麻醉恢复期更舒适、父母满意度更高。

Objective T o evaluate the effects of m idazolam in com fortably inducing technique in pediatric anesthesia. Methods 60 sick children for hypospadias neoplasty under general anesthesia w ith A SA I～II,aged 1.5～4,and body m ass of 10～20 kg w ere random ly divided into tw o groups.T he treatm ent group w ere given intravenous injection of m idazolam for 0 .08 m g/kg before inducing ,w hile the control group w ere given intravenous injection of ketam ine for 1 m g/kg before inducing.Sick children in both groups w ere accom panied by their parents during intravenous puncture and drug adm inistration before inducing.Sedation scales of the sick children before and after the drug adm inistration w ere conducted,and the heart rate,arterial oxygen saturation,and blood pressure w ere rocorded on entering room ,and tube draw ing tim e,adverse reaction after operation,and parents＇satisifaction w ere also recorded.There w as no behavior disorder of nightm are or depression .Results C om pared w ith the control group ,intravenous injection of m idazolam for 0 .08 m g/kg before inducing m ade the sick children sm ooth and steady in heart rate and blood pressure,w ith shorter tube draw ing tim e after operation and less adverse reaction ,and the differences w ere of statistical significance （P〈0 .05 ）.N o behavior disorder w as found in both groups after operation .Conclusion Intravenous injection of m idazolam for 0 .08 m g/kg for com fortably inducing technique in pediatric anesthesia can enhance the com pliance of the sick chil-dren for m edical care personnel w ith sm ooth and steady anesthesia induction ,com fortable anesthetic recovery period , and high parents＇ satisifaction .