艾司氯胺酮复合丙泊酚静脉麻醉联合骶管阻滞在小儿隐匿性阴茎成形术中的临床应用  

Clinical Application of Esketamine Combined with Propofol Intravenous Anesthesia Combined with Sacral Canal Block in Children with Occult Penoplasty

作　　者：张永贵[1] 赖小红 黄天堃[1] 何丁秀[1] ZHANG Yonggui;LAI Xiaohong;HUANG Tiankun;HE Dingxiu(The second Hospital of Longyan,Fujian Province,Longyan 364000,China;不详)

机构地区：[1]福建省龙岩市第二医院,福建龙岩364000

出　　处：《中国医学创新》2022年第36期163-167,共5页Medical Innovation of China

摘　　要：目的:探讨艾司氯胺酮复合丙泊酚静脉麻醉联合骶管阻滞在小儿隐匿性阴茎成形术中的安全性及麻醉效果。方法:选择2021年3月-2022年3月龙岩市第二医院收治的80例择期行隐匿性阴茎成形术患儿,采用随机数字表法将患儿分为ESK组和CON组,每组40例。ESK组采用艾司氯胺酮和丙泊酚静脉麻醉复合骶管阻滞,CON组采用丙泊酚静脉麻醉复合骶管阻滞。比较两组入手术室(T_(0))、骶管阻滞后10 min(T_(1))、手术开始30 min(T_(2))、手术结束(T_(3))的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_(2))、呼吸频率(RR);比较两组丙泊酚总用量、手术时长、苏醒时间、麻醉恢复室(PACU)停留时间及不良反应发生情况。结果:T_(0)时,两组HR、MAP、RR、SpO_(2)比较,差异均无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)时,CON组HR、MAP、RR、SpO_(2)均低于ESK组,差异均有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3)时,CON组MAP、HR、RR、SpO_(2)均低于T_(0),差异均有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3)时,ESK组MAP、HR、RR、SpO_(2)均低于T_(0),但差异均无统计学意义(P>0.05)。ESK组丙泊酚总用量少于CON组,苏醒时间、PACU停留时间均短于CON组,差异均有统计学意义(P<0.05)。两组手术时长比较,差异无统计学意义(P>0.05)。两组均未发生谵妄,两组躁动、恶心呕吐发生率比较,差异均无统计学意义(P>0.05)。ESK组呼吸抑制发生率低于CON组,差异有统计学意义(P<0.05)。结论:艾司氯胺酮复合丙泊酚静脉麻醉联合骶管阻滞用于小儿隐匿性阴茎成形术中生命征更平稳,不良反应发生率低,缩短麻醉后恢复时间,可加快术后康复。Objective:To investigate the safety and efficacy of Esketamine combined with Propofol intravenous anesthesia combined with sacral canal block in children with occult penoplasty.Method:A total of 80 children with occult penoplasty admitted to the Second Hospital of Longyan from March 2021 to March 2022 were selected,they were divided into ESK group and CON group by random number table method,with 40 cases in each group.ESK group received Esketamine and Propofol intravenous anesthesia combined with sacral canal block,and CON group received Propofol intravenous anesthesia combined with sacral canal block.Mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO_(2)),respiratory rate(RR)were compared between the two groups after admission to the operating room(T_(0)),10 min after sacral block(T_(1)),30 min after surgery(T_(2)),and at the end of surgery(T_(3));the total dosage of Propofol,surgical duration,wake time,PACU stay time and the occurrence of adverse reactions were compared between the two groups.Result:At T_(0),there were no significant differences in HR,MAP,RR and SpO_(2) between the two groups(P>0.05);at T_(1),T_(2) and T_(3),HR,MAP,RR and SpO_(2) in the CON group were lower than those in the ESK group,the differences were statistically significant(P<0.05).At T_(1),T_(2) and T_(3),MAP,HR,RR and SpO_(2) in the CON group were lower than those at T_(0),the differences were statistically significant(P<0.05).At T_(1),T_(2) and T_(3),MAP,HR,RR and SpO_(2) in the ESK group were lower than those at T_(0),but the differences were not statistically significant(P>0.05).The total dosage of Propofol in the ESK group was lower than that in the CON group,the wake time and PACU stay time in the ESK group were shorter than those in the CON group,the differences were statistically significant(P<0.05).There was no significant difference in surgical duration between the two groups(P>0.05).No delirium occurred in either group.There were no significant differences in the incidence of agitation,nausea and vomiting

关 键 词：艾司氯胺酮 骶管阻滞 丙泊酚 静脉麻醉 

分 类 号：R726.1[医药卫生—儿科]