地佐辛或氯胺酮配伍咪唑安定在小儿基础麻醉中的比较

目的比较地佐辛或氯胺酮配伍咪唑安定在急诊手外科患儿基础麻醉中的效果及不良反应。方法80例急诊手外科患儿，随机分为MD组（咪唑安定＋地佐辛）与MK组（咪唑安定＋氯胺酮）各40例，入手术室后两组均予以丙泊酚静脉推注，B超及神经刺激仪引导下行腋路神经阻滞。观察术中术后不良反应及苏醒情况及各时间点生命体征。结果与MK组比较，MD组麻醉后OSS／A评分≤4分起效时间延长，术中咳嗽，吞咽活跃发生率低，术后烦躁AFPs评分低，差异均有统计学意义。结论地佐辛配伍咪唑安定用于小儿基础麻醉与氯胺酮配伍咪唑安定比较，术中管理平稳麻醉并发症少，术后苏醒良好，但麻醉起效较慢。

Objective To compare effect of Dezocine and ketamine combined with midazolam in basal anesthesia to infants administered with emergency hand surgery. Methods Randomly divided 80 cases of infants administered with emergency hand surgery into MD group （ n=40 Intravenous injection of midazolam Dezocine ） and MK group （ n=40 Intravenous injection of midazolam ketamine ） . After entering the operation room, the two groups were all administered with intravenous injection of propofol and axillary nerve block guided by B-scan and nerve-stimulator. The adverse reaction during and after operation, and recovery condition and vital signs were observed at each time node. Result Compared with MK group, OSS/A score of MD group after anesthesia was up to 4 points, the time of taking effect was prolonged, cough was observed during operation, and incidence of swallowing activity was low, AFPS score of postoperative dysphoria was low. All above indices had significant difference. Conclusion Comparison of using Dezocine midazolam and ketamine midazolam in basal anesthesia for infants showed stable operative management and fewer complications, good recovery after operation, yet the anesthesia took effect slowly.