艾司氯胺酮联合咪达唑仑在小儿增强CT检查中的镇静效果观察

Observation of Sedative Effect of Esketamine Combined with Midazolam in Children with Contrast-enhanced CT Examination

目的:分析艾司氯胺酮联合咪达唑仑在小儿增强CT检查中的镇静效果及不良反应。方法:选择2021年6月-2022年2月福建省福州儿童医院行增强CT检查的患儿120例,以随机数字表法分为参照组(59例)和研究组(61例),参照组患儿增强CT检查前给予咪达唑仑静脉注射0.08 mg/kg,研究组患儿在参照组基础上给予艾司氯胺酮静脉注射0.3 mg/kg,观察用药前、开始检查、检查结束后两组患儿收缩压(SBP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO)水平,记录两组患儿镇静起效时间、睁眼时间、应答时间,采用Ramsay评分法评价两组患儿镇静效果,并比较两组患儿不良反应发生情况。结果:开始检查时,参照组SBP、HR较用药前升高,RR较用药前降低(P<0.05),研究组HR与用药前比较,差异无统计学意义(P>0.05),而SBP升高,RR降低(P<0.05),研究组SBP、HR较参照组低(P<0.05),RR较参照组高(P<0.05);检查结束后,研究组SBP较参照组低(P<0.05),两组HR、RR比较差异无统计学意义(P>0.05)。两组患儿睁眼时间、应答时间比较差异无统计学意义(P>0.05),研究组患儿镇静起效时间[(17.89±2.69)min]早于参照组[(24.71±3.42)min](P<0.05),研究组患儿Ramsay评分(4.72±0.93)分,高于参照组的(3.45±0.75)分(P<0.05)。参照组不良反应发生率为6.78%,与研究组的4.92%比较,差异无统计学意义(P>0.05)。结论:在小儿增强CT检查中采用艾司氯胺酮联合咪达唑仑进行镇静,可稳定患儿血流动力学,提升镇静效果,无不良反应增加,安全性高。

Objective:To analyze the sedative effect and adverse reactions of Esketamine combined with Midazolam in children with enhanced CT examination.Method:A total of 120 children who underwent enhanced CT examination in Fujian Fuzhou Children’s Hospital from June 2021 to February 2022 were selected and divided into the reference group (59 cases) and the study group (61 cases) according to the random number table method.The children in the reference group were given Midazolam intravenously injected 0.08 mg/kg before enhanced CT examination,on the basis of the reference group,the children in the study group were given Esketamine 0.3 mg/kg intravenously.The levels of systolic blood pressure (SBP),heart rate (HR),respiratory rate (RR) and blood oxygen saturation (SpO) of the two groups of children were observed before medication,at the beginning of examination and after examination.The sedation onset time,eye opening time and response time of the two groups of children were recorded.The sedation effect of the two groups of children was evaluated by Ramsay scoring method,and the adverse reactions of the two groups of children were compared.Result:At the beginning of the examination,SBP and HR of the reference group were increased compared with those before medication,and RR of the reference group was decreased compared with those before medication (P<0.05),there was no significant difference in HR of the study group compared with those before medication (P>0.05),but SBP was increased,RR was decreased (P<0.05),SBP and HR of the study group were lower than those of the reference group (P<0.05),RR was higher than that in the reference group (P<0.05).After the examination,the SBP of the study group was lower than that of the reference group (P<0.05),and there were no significant differences in HR and RR between the two groups (P>0.05).There was no significant difference in eye opening time and response time between the two groups (P>0.05).The sedation onset time of the study group was[(17.89±2.69) min]earlier than that of the reference group[(24.71±3.42) min](P<0.05).The Ramsay score of the study group[(4.72±0.93) points]was higher than that of the reference group[(3.45±0.75) points](P<0.05).The incidence of adverse reactions in the reference group was 6.78%,which was not significantly different from 4.92% in the study group (P>0.05).Conclusion:The sedation of Esketamine combined with Midazolam in enhanced CT examination of children can stabilize the hemodynamics of children,improve the sedation effect,without increasing adverse reactions,and has high safety.