口服咪达唑仑和氯胺酮用于小儿麻醉前用药的临床观察  

Oral midazolam combined with ketamine for premedication in children

作　　者：严海燕[1] 石景辉[2] 罗爱林[2] 

机构地区：[1]哈尔滨医科大学附属第一医院麻醉科,黑龙江哈尔滨150001 [2]华中科技大学同济医学院麻醉科,湖北武汉430030

出　　处：《哈尔滨医科大学学报》2013年第3期278-280,283,共4页Journal of Harbin Medical University

摘　　要：目的比较小儿肌肉注射氯胺酮,口服氯胺酮及口服咪达唑仑和氯胺酮混合液3种不同术前用药方法镇静效果,起效时间及患儿接受率。方法儿外科患者90例,随机分为3组:A组(术前肌肉注射氯胺酮5mg/kg,n=30);B组(术前口服氯胺酮6 mg/kg,加服50%葡萄糖至0.5 mL/kg,n=30);C组(术前口服咪达唑仑0.5 mg/kg和氯胺酮3 mg/kg,加服50%葡萄糖至0.5 mL/kg,n=30)。观察并记录患儿与家长分离时精神状态分级情况,术后第1天和第7天随访患儿家长,对患儿的行为学改变进行评估。结果 A组患儿接受率只有10%,而B,C组患儿接受率均在90%以上;B,C两组相比较而言,C组起效时间更快,镇静程度更好;在术后第1天和第7天随访发现,术前肌注氯胺酮的患儿行为学改变均较其余两组高。结论口服咪达唑仑和氯胺酮混合液作为术前药,起效快,效果确切,并能避免对儿童造成心理伤害,适宜作为小儿麻醉前用药。Objective To compare the sedative effect,the onset time and children receiving rate of three different premedication methods：intramuscular ketamine,oral ketamine and oral midazolam and ketamine in mixture.Methods Ninety patients before paediatric surgery were divided into 3 groups randomly：intramuscular ketamine 5 mg/kg （group A）,oral ketamine 6 mg/kg alone （group B）,or oral midazolam 0.5 mg/kg and ketamine 3 mg/kg （group C）,respectively.The parameters included sedation score before anaesthesia,reaction to separation with parents were observed,and children＇ s behavior changes were assessed on the first day and the seventh day after operation.Results The acceptance rate was only 10％ in group A,while were both above 90％ in group B and C.Compared with group B,group C had a faster onset time,better effect of sedation ; On the first postoperative day and on the seventh day follow-up,preoperative intramuscular injection had a higher rate of behavior changes.Conclusion Premedication with oral midazolam and ketamine is effective and well accepted by paediatric surgery patients,and can avoid psychological harm to children,it is suitable for pediatric premedication.

关 键 词：咪达唑仑 氯胺酮 麻醉前用药 

分 类 号：R614[医药卫生—麻醉学]