低龄小儿简骶麻两种静脉辅助方法的临床疗效比较  

作　　者：王展麟[1] 何卓文[1] 

机构地区：[1]广东肇庆市第一人民医院麻醉科,526020

出　　处：《中国社区医师（医学专业）》2010年第22期131-133,共3页

摘　　要：目的:通过对两种静脉浅全麻辅助方法疗效的比较,以往推荐较优越的一种。方法:选择即将进行腹股沟或会阴区手术的低龄小儿(2～6岁)60例,并随机分成简骶麻加异丙酚芬太尼组(PFS组,n=30)和简骶麻加咪唑安定氯胺酮麻醉组(DKS组,n=30)。前组于小儿入室后即行简骶麻醉,完成操作后再注射芬太尼和丙泊酚静脉诱导,持续微泵丙泊酚维持;后组则简骶麻后,用氯胺酮和咪唑安定诱导,静脉泵注氯胺酮维持。观察记录麻醉前后平均动脉压(MAP)、心率(HR)、呼吸频率(R)、脉搏氧饱和度(SPO2)的变化程度以及术后苏醒时间,术中术后躁动、呕吐等不良反应的发生率。结果:两组小儿的一般情况、麻醉前生命体征及手术时间差异均无显著性,麻醉后1、5、10、15分钟分别与麻醉前相比,PFS组和DKS组的MAP、SPO2均差异无显著性,而HR及R均呈显著性变化(P<0.01或P<0.05)。PFS组术后清醒时间较短,术中及术后躁动、呕吐等不良反应发生很少(P<0.01)。Objective：To recommend a better treatment by comparing 2 Intravenous Use of Mild General Anesthetics. Method：60 young （2 - 6 ） patients intending for inguinal or perineum operation were selected and divived into caudal anesthesia propofol and fentanyl added group （PFS group, n = 30） and caudal anesthesia midazolam ketaminge group （ DKS group, n = 30）. The former group of children were pilo anesthetized and injected with fentanyl and propofol intravenous induction, with fentanyl in micropump maintained continuously; the latter group were induced via midazolam and ketamine after caudal anesthesia, with ketamine maintained continuously. Change degree and postoperative recovery time of preoperative and postoperative Average arterial pressure （MAP）, heart rate （HR）, respiratory rate （R） , pulse oximetry （ SPO2 ） as well as incidence of reverse reaction including intraoperative and postoperative restlessnes, vomiting were observed and recorded. Compared with that before anesthesia, both MAP and SPO2 in PFS group and DKS group were not remarkably different 1, 5, 10, 15 min. after anesthesia with remarkable differences in HR and R （P〈0. 01 or P〈0.05）. PFS group had a shorter postoperative recovery time with low incidence of reverse effects such as intraoperative and postoperative restlessnes, vomiting （ P 〈 0.01 ）.

关 键 词：低龄小儿 两种辅助麻 疗效 比较 

分 类 号：R495.9[医药卫生—康复医学]