氯胺酮与骶管阻滞麻醉用于小儿下腹手术的临床观察

Clinical Observation of Ketamine and Fistula Block Anesthesia for Lower Abdominal Surgery in Children

目的探讨氯胺酮与骶管阻滞麻醉用于小儿下腹手术的临床效果。方法于2018年1月—2019年1月对该院接收的44例下腹手术患儿进行对照观察,根据接收时间分组,即前半年接收的下腹手术患儿22例纳入常规组(单纯氯胺酮麻醉),后半年接收的下腹手术患儿22例纳入研究组(氯胺酮与骶管阻滞麻醉)。结果研究组HR(116.8±20.8)次/min、MAP(63.4±12.5)mmHg低于常规组(134.7±20.9)次/min、(77.9±18.7)mmHg(t=2.847,P<0.05;t=3.023,P<0.05),两组SpO2(97.7±0.7)%VS(97.5±1.2)%指标对比无差异(t=0.675,P>0.05);研究组氯胺酮应用量(79.6±33.8)mg、苏醒时间(37.9±13.4)min少于常规组(141.2±50.6)mg、(72.3±19.8)min(t=4.748,P<0.05;t=6.748,P<0.05),两组手术时间(36.5±16.8)minVS(36.7±16.5)min,差异无统计学意义(t=0.039,P>0.05);研究组不良反应9.09%少于常规组22.73%(χ^2=6.953,P<0.05)。结论对于实施下腹手术的小儿,临床予以氯胺酮与骶管阻滞麻醉的效果更为确切,具有体征稳定、安全可靠、不良反应少、术后苏醒快等优势,值得在临床中进一步借鉴。

Objective To investigate the clinical effect of ketamine and fistula block anesthesia for lower abdominal surgery in children.Methods From January 2018 to January 2019,the patients underwent 44 cases of lower abdominal surgery received by our hospital.According to the receiving time group,22 children who underwent lower abdominal surgery received in the first half of the year were included in the routine group(sweet ketamine anesthesia).22 patients who underwent lower abdominal surgery in the second half of the year were enrolled in the study group(ketamine and fistula block anesthesia).Results The HR(116.8±20.8)times/min and MAP(63.4±12.5)mmHg in the study group were lower than those in the conventional group(134.7±20.9)times/min and(77.9±18.7)mmHg(t=2.847,P<0.05;t=3.023,P<0.05),there was no difference in the contrast between the two groups of SpO2(97.7±0.7)%vs(97.5±1.2)%(t=0.675,P>0.05);the application group ketamine application(79.6±33.8)mg,wake up The time(37.9±13.4)min was less than the conventional group(141.2±50.6)mg,(72.3±19.8)min(t=4.748,P<0.05;t=6.748,P<0.05).The operation time of the two groups(36.5±16.8)min vs(36.7±16.5)min.There was no significant difference,(t=0.039,P>0.05);9.09%of the adverse reactions in the study group was lower than that in the conventional group 22.73%(χ^2=6.953,P<0.05).Conclusion For children with lower abdominal surgery,the clinical effect of ketamine and fistula block anesthesia is more accurate.It has the advantages of stable signs,safety and reliability,less adverse reactions,and quick recovery after surgery.It is worthy of further reference in clinical practice.