罗哌卡因联合艾司氯胺酮在小儿多指手术中的应用效果

Effect of Ropivacaine Combined with Esketamine in Childrenwith Multi-finger Operation

目的 探讨罗哌卡因联合艾司氯胺酮在小儿多指手术中的应用价值。方法 回顾性选取2022年12月至2023年6月在医院接受多指切除术治疗的109例患儿纳入研究,按麻醉方案分为对照组(54例)、研究组(55例)。均接受腋路臂丛神经阻滞,其中接受罗哌卡因麻醉的纳入对照组,接受罗哌卡因联合艾司氯胺酮麻醉的纳入研究组。比较两组手术及麻醉情况。以术前(T_(0))、切皮时(T_(1))、切皮后10 min(T_(0))、20 min(T_(3))、30 min(T_(4))为时间节点,比较两组生命体征指标[心率、血氧饱和度、平均动脉压]水平。比较不同时间点(术前和术后3、6、12、24 h)儿童疼痛行为(FLACC)量表评分及不良反应、综合满意度。结果 研究组T_(2)~T_(4)时心率、平均动脉压均低于对照组(P<0.05);研究组术后3、6、12、24 h FLACC评分均低于对照组(P<0.05);研究组总满意度[96.36%(53/55)]高于对照组[81.48%(44/54)](P<0.05);研究组不良反应总发生率[5.45%(3/55)]与对照组[9.26%(5/54)]比较,差异无统计学意义(P>0.05)。结论 罗哌卡因联合艾司氯胺酮麻醉在小儿多指手术中的镇痛效果确切,能有效稳定术中患儿血流动力学水平,且安全性可靠,患儿家属对其整体满意度较高。

Objective To investigate the application value of ropivacaine combined with esketamine in pediatric multi-finger surgery.Methods A total of 109 children who received multi-finger resection in the hospital from December 2022 to June 2023 were retrospectively selected and divided into control group(54 cases)and study group(55 cases)according to anesthesia protocols.Both groups underwent axillary brachial plexus block.Children anesthetized with ropivacaine were included in the control group,and those anesthetized with ropivacaine combined with esketamine were included in the study group.The operation and anesthesia of the two groups were compared.The vital signs(heart rate,blood oxygen saturation and mean arterial pressure)of the two groups were compared before surgery(T_(0)),at incision time(T_(1)),10 minutes(T_(0)),20 minutes(T_(3))and 30 minutes(T_(4))after incision as time nodes.Children’s pain behavior(face,legs,activity,crying,consolability,FLACC)scale scores,adverse reactions and comprehensive satisfaction were compared at different time points(preoperative,postoperative 3,6,12,24 hours).Results The levels of heart rate and mean arterial pressure in the study group at T_(2)-T_(4) were lower than those in the control group(P<0.05).The FLACC scores of the study group at 3,6,12 and 24 hours after operation were lower than those of the control group(P<0.05).The total satisfaction of the study group[96.36%(53/55)]was higher than that[81.48%(44/54)]of the control group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the control group[9.26%(5/54)]and the study group[5.45%(3/55)](P>0.05).Conclusion Ropivacaine combined with esketamine anesthesia can effectively stabilize the hemodynamic level of children during the operation,and it is safe and reliable,and the overall satisfaction of the families of children is high.