艾司氯胺酮复合丙泊酚静脉麻醉对小儿腹腔镜疝修补术的应用  

Application of intravenous anesthesia with esketamine combined with propofol in laparoscopic hernia repair in children

作　　者：白鹏祖[1] 张利亮 张海盛[1] 张成奎[1] BAI Pengzu;ZHANG Liliang;ZHANG Haisheng;ZHANG Chengkui(Department of Anesthesiology,Qinghai Red Cross Hospital,Qinghai Xining 810000,China)

机构地区：[1]青海红十字医院麻醉科,青海西宁810000

出　　处：《中国妇幼健康研究》2022年第2期90-94,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的探究艾司氯胺酮复合丙泊酚静脉麻醉对小儿腹腔镜疝修补术的应用效果。方法选取2019年12月至2020年12月于青海红十字医院收治的92例行小儿腹腔镜疝修补术患儿为研究对象,使用随机数字表法分为对照组(n=46)和观察组(n=46)。对照组患儿予以氯胺酮全麻,观察组患儿予以艾司氯胺酮复合丙泊酚静脉麻醉,比较两组患儿入手术室前、麻醉诱导前焦虑水平、麻醉恢复情况、术后躁动及不良反应发生情况。结果两组患儿麻醉诱导前改良耶鲁围术期焦虑量表(mYPAS)得分均较入手术室前降低(t值分别为7.724、7.697,P<0.05),但两组患儿麻醉诱导前mYPAS得分差异不显著(P>0.05);观察组患儿自主呼吸时间、拔管时间、指令性睁眼时间、麻醉监测治疗室(PACU)停留时间均低于对照组,差异有统计学意义(t值分别为6.828、7.073、10.075、3.299,P<0.05);观察组患儿总体术后躁动情况得分及术后躁动发生率均低于对照组,差异有统计学意义(Z/χ^(2)值分别为7.802、3.903,P<0.05);两组患儿呕吐、喉痉挛、呼吸抑制、体温异常、苏醒延迟发生差异均无统计学意义(PFisher>0.05)。结论艾司氯胺酮复合丙泊酚静脉麻醉对小儿腹腔镜疝修补术患儿术前焦虑影响不显著,但能有效改善患儿麻醉恢复情况,减轻患儿术后躁动,且不会导致不良反应增加。Objective To explore the application effect of intravenous anesthesia with esketamine combined with propofol on children undergoing laparoscopic hernia repair.Methods A total of 92 children undergoing laparoscopic hernia repair,who were admitted to Qinghai Red Cross Hospital between December 2019 and December 2020,were selected as the research subjects,and they were divided into the control group(n=46)and the observation group(n=46)by using the random number table method.Children in the control group were given anesthesia with ketamine,and children in the observation group were given intravenous anesthesia with esketamine combined with propofol.The anxiety levels before entering the operating room and before anesthesia induction and the conditions of anesthesia recovery,postoperative agitation and occurrence of adverse reactions were compared between the two groups.Results The scores of modified Yale Perioperative Anxiety Scale(mYPAS)of the two groups before anesthesia induction were lower than those before entering the operating room(t=7.724 and 7.697,respectively,P<0.05),but the difference in mYPAS score between the two groups before anesthesia induction was not significant(P>0.05).The spontaneous breathing time,extubation time,indicative eye opening time and post anesthesia care unit(PACU)stay in the observation group were shorter than those in the control group,and the differences were statistically significant(t=6.828,7.073,10.075 and 3.299,respectively,P<0.05).The overall postoperative agitation score and incidence rate of postoperative agitation in the observation group were lower than those in the control group,and the differences were statistically significant(Z/χ^(2)=7.802 and 3.903,respectively,P<0.05).There were no statistical differences in the occurrence of vomiting,laryngospasm,respiratory depression,abnormal body temperature and delayed recovery between the two groups(PFisher>0.05).Conclusion Intravenous anesthesia with esketamine combined with propofol has no significant effect on preoperative a

关 键 词：艾司氯胺酮 丙泊酚 静脉麻醉 小儿腹腔镜疝修补术 

分 类 号：R726.1[医药卫生—儿科]