氯胺酮与利多卡因在儿童麻醉诱导中应用的可行性研究  

Feasibility of Ketamine-lidocaine Anaesthetic Induction in Pediatric Patients

作　　者：孙艳霞[1] 盛开花[1] 李天佐[1] 纪方[1] 张炳熙[1] 

机构地区：[1]首都医科大学附属北京同仁医院麻醉科

出　　处：《首都医科大学学报》2005年第2期207-210,共4页Journal of Capital Medical University

基　　金：北京卫生重点学科扶植项目(1999卫科扶字06号)资助项目

摘　　要：目的探讨氯胺酮与利多卡因合剂(氯利合剂)用于儿童全麻诱导的可行性.方法将40例ASA Ⅰ～Ⅱ级行择期手术的患儿分成2组,每组20人,A组为氯胺酮麻醉诱导组,B组为氯利合剂麻醉诱导组,观察诱导过程中血流动力学的变化,评估插管条件并记录术后并发症.结果在诱导过程中,B组的心血管反应轻微,与A组比较差异有统计学意义(P<0.05);虽然2组的插管条件可接受率没有差异,但是B组暴露喉镜明显较A组容易(P<0.05),也没有发生呛咳,而A组呛咳发生率为30%,2组比较差异有统计学意义(P<0.05);术后2组病人均未发生幻觉、噩梦等精神系统不良反应,但A组恶心、呕吐的发生率显著高于B组(P<0.05).结论氯利合剂用于儿科麻醉诱导具有血流动力学稳定,气管插管条件良好,术后恶心、呕吐发生率低的优点,用于儿童的麻醉诱导是可行的.Objective To study the feasibility of the combination of ketamine with lidocaine for anesthesia induction in children. Methods Altogether 40 ASA physical status Ⅰ～Ⅱ children undergoing selective surgery were randomly divided into two groups of 20 each. Group A received ketamine and group B received the combination of ketamine and lidocaine for induction. Results During the induction, the changes of hemodynamics were observed,the intubation conditions were assessed as acceptable or unacceptable; the post anesthesia side-effects were recorded in all patients. The difference of cardiovascular response between two groups was significant(P<0.05). Although intubation conditions had no significant difference between two groups, laryngoscopy was easier in group B compared with group A(P< 0.05) and there was no coughing in group B(P<0.05). No patient in two groups reported post operation psycho-side-effects such as hallucination, but the incidence of post operation nausea and vomiting (PONV) in group A were higher than those in group B(P<0.05). Conclusion Ketamine-lidocaine anesthetic applied for children induction has the advantages of hemodynamics stability, acceptable intubation conditions and low incidence of PONV. The combination of ketamine with lidocaine for anesthesia induction of children is suitable.

关 键 词：麻醉诱导 氯胺酮 儿童 血流动力学 氯利合剂 利多卡因合剂 气管插管条件 术后并发症 心血管反应 发生率 全麻诱导 择期手术 不良反应 精神系统 术后恶心 统计学 B组 ASA 接受率 呛咳 呕吐 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]