氯胺酮与氟烷用于小儿短小手术麻醉的比较  

Comparing of ketamine and halothane anesthesia for children undergoing little operation

作　　者：李松梅[1] 徐海霞[1] 

机构地区：[1]河南大学淮河医院,开封475000

出　　处：《中原医刊》2006年第7期15-16,共2页Central Plains Medical Journal

摘　　要：目的 比较氟胺酮与氟烷用于小儿短小手术麻醉的优缺点。方法 选择行短小手术的患儿300例。ASA（美国麻醉医师协会病情分级法）Ⅰ-Ⅱ级，年龄4—6岁，患儿身高、体重差异无统计学意义。300例患儿分为两组，每组150例。一组为中国儿童．选用氯胺酮麻醉，为KTM组；另一组为赞比亚儿童，选用氟烷麻醉，为HLT组。两组患儿术中均监测心电图（ECG）、心率（HR）、呼吸频率（RR）、血压（BP）和脉搏氧饱和度（SpO2）；观察比较两组患儿术中呼吸抑制发生例数（A）、术后苏醒时间（B）、术后恶心呕吐发生例数（C）、术后精神症状发生例数（D）及术后7d内黄疸发生例数（E）。结果 两组患者术中ECG均为窦性心律；SpO2均可维持在96％-100％，但当呼吸抑制发生时，SpO2下降；麻醉开始时，HLT组患者HR、RR均增快，手术开始后HR、RR均减慢至接近术前水平，KTM组麻醉开始时HR增快，手术开始后仍快于术前水平，两组相比差异有统计学意义（P〈0．05），KTM组麻醉开始时呼吸浅慢，甚至发生一过性呼吸抑制，手术开始后RR增快，两组相比差异有统计学意义（P〈0．05）；麻醉开始时，两组患儿BP均升高。手术开始后HLT组降至术前水平，KTM组仍高于术前水平，两组相比差异有统计学意义（P〈0．05）；术中呼吸抑制发生例数，HLT组显著低于KTM组，P〈0．05；术后苏醒时间，HLT组显著短于KTM组，P〈0．05；术后恶心呕吐发生例数，HIT组显著低于KTM组，P〈0．05；苏醒期锥体外系症状发生例数，HLT组显著低于KTM组，P〈0.05；术后7d内黄疽发生例数，两组均为0，差异无统计学意义，P〉0．05。结论 氟烷用于小儿短小手术的麻醉优于氯胺酮。Objective To compare ketamine and halothane anesthesia for children undergoing little operation. Methods 300 patients （ASA Ⅰ-Ⅱ ） undergoing little operation were selected and were divided into two groups. There were 150 patients in each group. The groups with Chinese children were used ketamine anesthesia（ KTM group）. The group with Zambian children were used halothane anesthesia （HLT group）. There was no significant difference in patients＇ age （4 - 6 years old）, body wight or stature between the two groups. The patient S＇ ECG, HR, RR, BP and SpO2 were monitored during operation. Observe the number of breathing inhibit （A）, recovery time （ B ）, postoperative nausea and vomiting （ C ）, postoperative mental symptom （ D ） and jaundice in postoperative 7 days（E）. Results The ECG and SpO2 were normal in two groups,but SpO2 went down when breath inhibit occured,in group HLT the number of breath inhibit was markedly lower than that in group KTM （ P 〈 0.05 ）. HR and RR increased in HLT group when anesthesia was beginning, HR in group HLT went down and in KTM group was still fast during operation （ P 〈 0.05 ）. in both group, Bp was going up when anesthesia was beginning, but it went down to normal level in group HLT and still high in group KTM during operation （ P 〈 0.05 ）. In group HLT, recovery time was markedly shorter than that in group KTM （P 〈 0.05 ）. In group HLT, the number of nausea and vomiting was markedly lower than that in group KTM （P 〈 0.05 ）. In group HLT, the number of postoperative mental symptom was significantly lower than that in group KTM（ P 〈0.05 ）. In both groups,There was no jaundice postoperative （ P 〉0.05 ）. Conclusion Halothane is better than ketamine for children＇s anesthesia in little operation.

关 键 词：氟胺酮 氟烷 麻醉 小儿 短小手术 

分 类 号：R726.1[医药卫生—儿科]