骶管麻醉复合氯胺酮和咪达唑仑用于小儿腹股沟疝手术临床观察  

The Clinical Study of Sacral Block Combined with Ketamine and Midazolam

作　　者：魏俊生[1] 陶孝池[1] 

机构地区：[1]池州市第二人民医院麻醉科,安徽247000

出　　处：《安徽卫生职业技术学院学报》2010年第2期20-21,共2页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:探讨骶管麻醉复合氯胺酮和咪达唑仑用于小儿腹股沟疝手术的临床效果。方法:60例腹股沟疝患儿随机分为骶管阻滞复合氯胺酮咪达唑仑麻醉组(SKM组,n=30)和氯胺酮复合咪达唑仑麻醉组(KM组,n=30),观察麻醉过程中平均动脉压(MAP)、心率(HR)和呼吸频率(RR)变化,比较两组术中氯胺酮用量、术后清醒时间、躁动呕吐不良反应的发生率。结果KM组麻醉过程中MAP显著升高(P<0.01),HR和RR显著增快(P<0.01和P<0.05),而SKM组麻醉过程中MAP、HR、RR无明显变化(P>0.05)。与KM组比较,SKM组术中氯胺酮用量少(P<0.01),术后清醒时间短(P<0.01),躁动、呕吐不良反应发生少(P<0.05)。结论:骶管阻滞复合氯胺酮和咪达唑仑麻醉用于小儿腹股沟疝的手术,可减少单纯使用氯胺酮的使用量,从而减少氯胺酮用后苏醒过程中躁动、呕吐与不良发应的发生率。Objective： To explore the efficacy and safety of sacral block combined with ketamine and midazolam in pediatric inguinal hernia operation. Methods： Sixty patients underwent pediatric inguinal hernia operation were randomly divided into two groups： sacral block combined with ketamine and midazolam group （group SKM, n=30） and ketamine combined with midazolam group （group KM,n=30）. The mean arterial blood pressure （MAP）, heart rate （HR） and respiratory rate （RR） were recorded before,during and after anesthesia. The dosage of ketamine, wake time and adverse reaction of restlessness and vomit was compared between the two groups. Results： The post-anesthesia MAP,HR and RR were significantly increased than its pre-anesthesia level in group KM （P〈0.01 or P〈0.05）. While there was no significant difference of above parameters than its pre-anesthesia level in group SKM （P〉0.05）. The dosage of ketamine, wake time,adverse reaction of restlessness and vomit in group SKM were remarkably lower or shorter than those in group KM （P〈0.01 or P〈0.05）. Conclusion： With stable respiration and circulation,less dosage of ketamine, shorter wake time, less adverse reaction of restlessness and vomit, sacral block combined with ketamine and midazolam has better clinical effect than ketamine combined with midazolam in pediatric inguinal hernia operation.

关 键 词：骶管麻醉 氯胺酮 咪达唑仑 小儿 

分 类 号：R726.562[医药卫生—儿科]