艾司氯胺酮联合骶麻在儿童疝气手术中的应用效果  

Application effect of Esketamine combined with sacral anesthesia in children′s hernia surgery

作　　者：李婷 朱剑斌 姜闽英 LI Ting;ZHU Jianbin;JIANG Minying(Department of Anesthesiology,Nanping First Hospital,Fujian Province,Nanping 353100,China)

机构地区：[1]南平市第一医院麻醉科,福建南平353100

出　　处：《中国当代医药》2022年第18期111-114,共4页China Modern Medicine

摘　　要：目的探究与分析艾司氯胺酮联合骶麻在儿童疝气手术中的应用。方法选取2020年5月至2021年5月福建省南平市第一医院的98例儿童疝气手术患儿作为研究对象,采取随机数字表法分为对照组与观察组,各49例,对照组采用七氟烷吸入复合骶管麻醉,观察组采用艾司氯胺酮+七氟烷吸入复合骶管麻醉,比较两组围手术期心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、麻醉后体动(睁眼)时间、出手术室时间、完全清醒时间以及围手术期不良反应总发生率。比较两组苏醒后不同时间点的改良面部表情评分法(FLACC)评分。结果观察组麻醉穿刺时、麻醉后30 min、手术结束时HR、MAP值均低于对照组,差异有统计学意义(P<0.05)。观察组体动(睁眼)时间、出手术室时间及完全清醒时间均短于对照组,差异有统计学意义(P<0.05)。观察组苏醒后4、8、24及48 h的FLACC评分均低于对照组,差异有统计学意义(P<0.05)。两组围手术期不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在七氟烷吸入复合骶管麻醉基础上加用艾司氯胺酮应用于儿童疝气中可保证围手术期指标更加平稳,麻醉后苏醒时间及出手术室时间均较短,术后疼痛感更低,且围手术期无明显不良反应,安全性较高。Objective To explore and analyze the application of Esketamine combined with sacral anesthesia in children′s hernia surgery.Methods From May 2020 to May 2021,98 children with hernia surgery in Nanping First Hospital were selected as the research objects,and divided into the control group and the observation group by random number table method,49 cases in each group.The Sevoflurane inhalation combined with caudal anesthesia was used in the control group.The observation group was treated with Esketamine combined with sacral anesthsia.The perioperative heart rate(HR),mean arterial pressure(MAP)and blood oxygen saturation,the time of body movement(eye opening)after anesthesia,the time to leave the operating room,the time to fully wake up,the total incidence of perioperative adverse reactions were compared between the two groups,and modified faces,legs,activity,cry and consolability scale(FLACC)score at different time points after waking up were compared between the two groups.Results The HR and MAP values of the observation group were lower than those of the control group at the time of anesthesia puncture,30 min after anesthesia,and at the end of the operation,and the differences were statistically significant(P<0.05).The time of body movement(eye opening),the time to leave the operating room and the time to fully wake up in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The FLACC score of the observation group at 4,8,24 and 48 h after wake up were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of perioperative adverse reactions between the two groups(P>0.05).Conclusion On the basis of Sevoflurane inhalation combined with sacral anesthesia and Esketamine applied to children with hernia,the perioperative indicators can be more stable,the recovery time after anesthesia and the time out of the operating room are shorter,and the post

关 键 词：艾司氯胺酮 骶麻 儿童疝气手术 围手术期 麻醉苏醒 疼痛 不良反应 

分 类 号：R614[医药卫生—麻醉学]