艾司氯胺酮复合骶管阻滞麻醉在小儿下腹部手术中的应用效果研究  

Study on application effect of esketamine combined with sacral block anesthesia in pediatric lower abdominal surgery

作　　者：闫鑫[1] 汪慧娟 YAN Xin;WANG Hui-juan(Department of Anesthesia and Perioperative Medicine,Shihezi People's Hospital,Shihezi 832000,China)

机构地区：[1]新疆石河子市人民医院麻醉与围术期医学科,832000 [2]新疆石河子妇幼保健院妇保科,832000

出　　处：《中国现代药物应用》2025年第2期1-4,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探究艾司氯胺酮复合骶管阻滞麻醉在小儿下腹部手术中的应用效果。方法 将64例行下腹部手术患儿作为研究对象,基于随机数字表法将患儿分为观察组与对照组,各32例。对照组患儿给予全身麻醉(全麻)复合骶管阻滞麻醉,观察组患儿给予艾司氯胺酮预处理后行超声引导下骶管阻滞麻醉。对比两组患儿血流动力学指标、相关麻醉指标、认知功能及不良反应发生率。结果 两组麻醉前(T0)的舒张压(DBP)、收缩压(SBP)、心率(HR)对比,无统计学差异(P>0.05);观察组麻醉后15 min(T1)、麻醉后30 min(T2)、手术结束时(T3)的DBP、SBP、HR均低于对照组(P<0.05)。观察组患儿麻醉苏醒时间(12.27±5.78)min、恢复室停留时间(20.04±4.72)min均明显短于对照组的(20.31±7.24)、(32.75±5.68)min,苏醒期躁动发生率6.25%低于对照组的25.00%(P<0.05)。观察组患儿术后6、12 h的认知功能评分分别为(20.16±5.14)、(24.16±5.08)分,均明显高于对照组的(16.02±4.82)、(18.67±4.83)分(P<0.05)。观察组患儿不良反应发生率6.25%(2/32)与对照组的12.50%(4/32)对比无统计学差异(P>0.05)。结论 在小儿下腹部手术麻醉中,艾司氯胺酮复合骶管阻滞麻醉效果显著,可有效稳定患儿的血流动力学指标,改善认知水平,降低苏醒期躁动发生率,值得推广应用。Objective To explore the application effect of esketamine combined with sacral block anesthesia in pediatric lower abdominal surgery.Methods 64 pediatric patients who underwent lower abdominal surgery were selected as the study subjects.Based on the random number table method,the patients were divided into an observation group and a control group,with 32 cases in each group.The control group received general anesthesia combined with sacral block anesthesia,while the observation group received ultrasound-guided sacral block anesthesia after pretreatment with esketamine.The hemodynamic indicators,anesthesia indexes,cognitive function and incidence of adverse reactions were compared between the two groups.Results There were no statistical differences in diastolic blood pressure(DBP),systolic blood pressure(SBP) and heart rate(HR) before anesthesia(T0) between the two groups(P>0.05).DBP,SBP and HR in the observation group were lower than those in the control group 15 min after anesthesia(T1),30 min after anesthesia(T2) and at the end of surgery(T3)(P<0.05).The awakening time and recovery room stay were(12.27±5.78) and(20.04±4.72) min in the observation group,which were obviously shorter than(20.31±7.24) and(32.75±5.68) min in the control group;the incidence of agitation during the recovery period of 6.25% in the observation group was lower than 25.00% in the control group(P<0.05).The cognitive function scores of the observation group at 6 and 12 h after surgery were(20.16±5.14) and(24.16±5.08) points,which were significantly higher than(16.02±4.82) and(18.67± 4.83) points of the control group(P<0.05).The incidence of adverse reactions in the observation group was 6.25%(2/32),which had no statistical difference compared with 12.50%(4/32) in the control group(P>0.05).Conclusion In anesthesia for pediatric low abdominal surgery,the combination of esketamine and sacral block anesthesia has a significant effect,which can effectively stabilize the hemodynamic indicators of children,improve cognitive level,and reduc

关 键 词：小儿 下腹部手术 艾司氯胺酮 骶管阻滞麻醉 效果 

分 类 号：R726.1[医药卫生—儿科]