小剂量丙泊酚联合氯胺酮镇静对骨科小儿安全  

Safety and cognitive function study of low-dose Ketamine applied to pediatric patients

作　　者：张斌[1] 董楠[1] 杨君君[2] 张晓庆[2] 彭生[2] 

机构地区：[1]江苏无锡市第四人民医院麻醉科,无锡214062 [2]同济大学附属同济医院麻醉科,上海200065

出　　处：《外科研究与新技术》2014年第2期96-98,共3页Surgical Research and New Technique

基　　金：国家自然科学基金(811000469);江苏省卫生厅科研课题(H201070)

摘　　要：目的探讨小剂量氯胺酮用于小儿换药时镇静的安全性及对认知功能影响。方法 4-9岁骨科需要换药的小儿80例,随机分为2组,每组40例。A组:氯胺酮1.0 mg/kg+脂肪乳(丙泊酚对照剂)。B组:氯胺酮0.5 mg/kg+丙泊酚0.5 mg/kg,换药前静脉给药。记录镇静时间、定向力恢复时间患儿体动、低氧及换药后恶心、呕吐发生。结果两种方法都可以安全用于小儿换药;B组镇静时间及定向力恢复时间均短于A组,两组术后6小时认知功能差异无统计学意义;B组换药时体动及术后恶心显著少于A组。结论本研究剂量下氯胺酮可安全用于小儿换药,对术后6 h认知功能无影响。复合丙泊酚可以加快清醒,减少换药后恶心的发生。objective To study the safety and cognitive function of low-dose ketamine applied to pediatric orthopedic patients who need dressing change. Methods eighty cases 4-9 years old pediatric patients were selected,and randomly divided into two groups(n=40). A group: ketamine 1.0 mg/kg+lipid emulsion(used as control),B group: ketamine 0.5mg/kg+propofol 0.5 mg/kg,intravenous injection before dressing change. The time for continuous sedative,the time for orientation recovery,body movement and incidence of nausea following operation were recorded. Results Ketamine can be safely used for dressing change in both groups' children. The time for continuous sedative and the time for orientation recovery in group B significant are less than those in group A,postoperative cognitive function showed no significant difference 6 hours later,but body movement and incidence of nausea following dressing change were significantly less in group B,compared with group A. Conclusions Low- dose ketamine can be safely used in pediatric dressing change,and does not affect cognitive function at the sixth hours following dressing change. Combined use of propofol with ketamine can speed wakefulness,and reduce the incidence of nausea after dressing change.

关 键 词：小剂量氯胺酮 安全性 认知功能 小儿 

分 类 号：R726.1[医药卫生—儿科]