静脉全麻复合骶管麻醉在小儿输尿管镜手术中的应用  

Ketamine combined with sacral anesthesia for ureteroscope surgery in children

作　　者：朱咏仪[1] 赵年章[1] 金楠[1] 赖德辉[2] 

机构地区：[1]广州医学院港湾医院麻醉科,广东广州510700 [2]广州医学院港湾医院泌尿外科,广东广州510700

出　　处：《海南医学》2011年第16期53-54,共2页Hainan Medical Journal

摘　　要：目的观察氯胺酮复合骶管麻醉在小儿经尿道输尿管镜检查手术中的临床疗效及安全性。方法选择择期输尿管镜手术患儿40例,年龄2～5岁,ASAI～Ⅱ级,随机均分成两组。A组单纯予氯胺酮、异丙酚,B组予氯胺酮、异丙酚复合小儿骶管麻醉,观察入室时(T1)、手术中(操作时)(T2)及手术结束后(T3)患儿的HR、SpO2及MAP变化,术中氯胺酮用量及苏醒时间,术中及术后躁动、呕吐等不良反应的发生率。结果 B组氯胺酮总用量较A组明显减少(P<0.05),MAP、HR波动小于A组,患儿苏醒较A组快,术中及术后躁动、呕吐等不良反应发生少(P<0.01),两组SpO2维持在95%以上。结论静脉氯胺酮异丙酚复合骶管麻醉用于小儿经尿道输尿管镜手术是安全可行的。Objective To investigate the clinical efficacy and safety of ketamine combined with sacral anesthesia for ureteroscope surgery in children.Methods Forty children of 2~5 years old（ASAⅠ～Ⅱ） undergoing ureteroscopes surgery were randomly divided into two groups.Cases in group A received ketamine combined with sacral anesthesia,while those in group B received simple ketamine anesthesia.The changes of HR,SpO2 and MAP,the dosage of ketamine,the recovery time and the occurrence rate of restlessness and vomiting were observed in different periods of T1（pre-operation）,T2（during operation） and T3（post-operation）.Results The total dosage of ketamine in group A significantly reduced compared with that in group B（P〈0.05）.There were more fluctuation on HR,MAP in group B and the cases were awake slower in group B.The adverse reactions such as restlessness and vomiting occurred less in group A（P〈0.01）.4 cases with respiratory depression in group B were given barotropic support and SpO2 rebounded to more than 95%.Cases could cooperate better in group A.Conclusion Ketamine combined with sacral anesthesia is safe and feasible to be used to ureteroscope surgery among children.

关 键 词：氯胺酮 骶管麻醉 小儿 输尿管镜手术 

分 类 号：R726.1[医药卫生—儿科]