摘要
①目的 探讨小儿下腹部手术术后理想的镇痛方法。②方法 将 78例ASAⅠ～Ⅱ级择期手术病儿随机分为 3组 ,每组 2 6例。氯胺酮组术中间断静脉推注氯胺酮 1 .0 0～ 1 .50mg/kg维持和加深麻醉 ;罗哌卡因组骶部硬膜外注入罗哌卡因 1mL/kg(2 .5～ 3 .0g/L) ;罗哌卡因加氯胺酮组骶部硬膜外注入罗哌卡因 1mL/kg(2 .5～3 .0 g/L) ,氯胺酮 0 .2 5mg/kg。采用修改的客观疼痛评分法 (OPS)评定术后的镇痛效果 ,Ramsay法评定术后镇静效果。③结果 罗哌卡因加氯胺酮组术后 1、4、1 2、2 4hOPS评分明显低于氯胺酮组 ,差异有显著性 (F =5 .960～31 .555 ,q=4.72 6～ 1 0 .0 95 ,P <0 .0 1 ) ;罗哌卡因加氯胺酮组术后 1 2、2 4hOPS评分明显低于罗哌卡因组 ,差异有显著性 (q =6 .699、3 .42 5 ,P <0 .0 5、0 .0 1 )。氯胺酮组术后 1 2、2 4hRamsay评分明显低于罗哌卡因组、罗哌卡因加氯胺酮组 ,差异有显著性 (F =2 0 .41 1、2 7.845 ,q =7.657～ 9.699,P <0 .0 1 )。 ④结论 罗哌卡因复合氯胺酮骶部硬膜外注入用于小儿下腹部手术术后镇痛效果好 ,安全 。
Objective\ To study an ideal method of postoperative analgesia for lower abdominal surgery in children. Methods\ Seventy eight pediatric patients of ASA gradeⅠ-Ⅱ undergoing selective operation were randomly divided into 3 groups, 26 for each group :ketamine group (group 1), ropivacaine group (group 2) and ropivacaine plus ketamine group (group 3). Group 1: ketamin 1.00-1.50 mg/kg intermittent intravenous injection during operation to maintain and enhance anesthesia; Group 2: ropivacaine 1 mL/kg(2.5-3.0 g/L) was given epidurally; Group 3: ketamine 0.25 mg/kg plus ropivacaine, 1 mL/kg, epidurally. Postoperative analgesia was appraised with modified OPS and Ramsays.\ Results\ At 1, 4, 12 and 24 h postoperatively, OPS scores were markedly lower in Group 3 as compared with Group 1, the difference was significant( F =5.960-31.555, q =4.726-10.095, P <0.01); at 12 and 24 h postoperatively, OPS score showed that Group 3 was mach lower than Group 1, the difference was significant( q =6.999, 3.425, P <0.05,0.01). On Ramsay score at 12 and 24 h after operation, Group 1 was much lower than both Groups 2 and 3, the difference was significant( F =20.411, 27.845, q =7.657-9.699, P <0.01).\ Conclusion By injection of both ropivacaine and ketamine into sacral epidural area may get satisfactory analgesia for children after operation for lower abdomen. It is safe and without adverse reactions.
出处
《齐鲁医学杂志》
2003年第2期168-169,共2页
Medical Journal of Qilu
