咪唑安定复合氯胺酮用于小儿基础麻醉的临床研究  

A clinical study of muscular injection or oral administration of midazolam combined with ketamine for induction in children

作　　者：华海音[1] 杨广[1] 刘克玄[1] 陈秉学[1] 黄文起[1] 何广芬[1] 冯霞[1] 

机构地区：[1]中山医科大学附属第一医院麻醉科,广州市510080

出　　处：《临床麻醉学杂志》2001年第3期127-129,共3页Journal of Clinical Anesthesiology

摘　　要：目的　研究咪唑安定复合氯胺酮肌注或口服用于小儿基础麻醉的可能性。方法　 80例 1～ 8岁、ASAⅠ～Ⅱ级的患儿随机等分成四组 :A组 ,肌注氯胺酮 6mg/kg ;B组 ,肌注氯胺酮 4mg/kg +口服咪唑安定 0 2mg/kg ;C组 ,口服氯胺酮 5mg/kg +咪唑安定 0 5mg/kg ;D组 ,口服咪唑安定0 7mg/kg。观察各组麻醉诱导效果、循环呼吸变化及不良反应。 结果　 (1)B组与A组相比 ,起效更快 ,术中不良反应发生率更低 (P <0 0 5 ) ,而麻醉诱导效果无明显差异 (P >0 0 5 ) ;(2 )C组与A组相比 ,小儿更为合作 (P <0 0 1) ,HR增加不明显 (P >0 0 5 ) ,但起效更慢 (P <0 0 5 ) ,镇静程度不如后者 (P <0 0 5 ) ,但 80 %的患儿尚能与父母分离。结论　咪唑安定复合氯胺酮肌注用于小儿麻醉诱导要优于单纯肌注氯胺酮 ,而咪唑安定复合氯胺酮口服仍不失为一种可行的诱导方法。Objective To investigate the possibility of muscular injection or oral administration of midazolam combined with ketamine for the induction in children.Methods 80 children,aged 1 to 8,ASAgrades Ⅰ-Ⅱ,were divided randomly into four groups:group A, ketamine 6mg/kg im,group B,ketamine 4mg/kg +midazolam 0 2mg/kg im, group C,ketamine 5mg/kg +midazolam 0 5mg/kg po,group D,midazolam 0 7mg/kg po. The efficacy of anesthsia induction,hemodynamic and respiratory changes and side effects of the drugs administered were observed.Results (1)Compared to group A,group B experienced faster onset and fewer side effects ( P< 0 05),while the efficacy of induction had no significant difference ( P> 0 05).(2)Compared to group A,children in group C could cooperate better with out obvious heart rate increase ( P> 0 05),but experienced slower onset and worse induction quality ( P< 0 05).80% of patients in group C could separate from their parents.Conclusion Intramuscular injection of midazolam combined with ketamine is a better method than ketamine im alone for basic anesthesia in child.Oral administration of midazolam combined with ketamine is still an alternative method.

关 键 词：咪唑安定 氯胺酮 基础麻醉 儿童 

分 类 号：R726.5[医药卫生—儿科] R614.2[医药卫生—临床医学]