中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
1期
63-64
,共2页
腰麻-硬膜外联合麻醉%小儿%氯胺酮%临床应用
腰痳-硬膜外聯閤痳醉%小兒%氯胺酮%臨床應用
요마-경막외연합마취%소인%록알동%림상응용
spillal anesthesia-epidural anesthesia%Children%Ketamine%Clinical application
目的 观察腰麻一硬膜外联合加氯胺酮麻醉在小儿下腹及下肢手术中的麻醉效果及其并发症.方法 将50例1～5岁患儿完全随机分为A、B两组,每组25例,A组行腰麻-硬膜外联合加氯胺酮麻醉,B组行氯胺酮静脉复合麻醉,观察比较2组术中氯胺酮用量,镇痛及肌松效果,麻醉苏醒时间及并发症.结果 手术开始后0、5、10 min,B组的心率、平均动脉压与A组相比明显增加(P<0.01).而呼吸的抑制程度则A组低于B组.手术开始后5 min表现最为明显.手术开始后15 min则2组各参数接近基础麻醉后水平.镇痛效果:A组25例均为Ⅰ级;B组16例为Ⅰ级,9例为Ⅱ级;肌肉松弛效果:A组25例均为优,B组11例为优,8例为良,6例为差.2组镇痛及肌肉松弛效果比较,差异有统计学意义(P<0.01).A组氯胺酮总量明显少于B组.A组无头痛及脊神经损害等症状,B组中有5例发生喉痉挛;苏醒期A组2例躁动,1例出现精神症状,1例呕吐.B组7例躁动,4例出现精神症状,3例呕吐.结论 腰麻-硬膜外联合加氯胺酮麻醉应用于小儿下腹及下肢手术具有麻醉效果确切、全身麻醉药用量较少、术后苏醒快、不良反应较少等优点.
目的 觀察腰痳一硬膜外聯閤加氯胺酮痳醉在小兒下腹及下肢手術中的痳醉效果及其併髮癥.方法 將50例1～5歲患兒完全隨機分為A、B兩組,每組25例,A組行腰痳-硬膜外聯閤加氯胺酮痳醉,B組行氯胺酮靜脈複閤痳醉,觀察比較2組術中氯胺酮用量,鎮痛及肌鬆效果,痳醉囌醒時間及併髮癥.結果 手術開始後0、5、10 min,B組的心率、平均動脈壓與A組相比明顯增加(P<0.01).而呼吸的抑製程度則A組低于B組.手術開始後5 min錶現最為明顯.手術開始後15 min則2組各參數接近基礎痳醉後水平.鎮痛效果:A組25例均為Ⅰ級;B組16例為Ⅰ級,9例為Ⅱ級;肌肉鬆弛效果:A組25例均為優,B組11例為優,8例為良,6例為差.2組鎮痛及肌肉鬆弛效果比較,差異有統計學意義(P<0.01).A組氯胺酮總量明顯少于B組.A組無頭痛及脊神經損害等癥狀,B組中有5例髮生喉痙攣;囌醒期A組2例躁動,1例齣現精神癥狀,1例嘔吐.B組7例躁動,4例齣現精神癥狀,3例嘔吐.結論 腰痳-硬膜外聯閤加氯胺酮痳醉應用于小兒下腹及下肢手術具有痳醉效果確切、全身痳醉藥用量較少、術後囌醒快、不良反應較少等優點.
목적 관찰요마일경막외연합가록알동마취재소인하복급하지수술중적마취효과급기병발증.방법 장50례1～5세환인완전수궤분위A、B량조,매조25례,A조행요마-경막외연합가록알동마취,B조행록알동정맥복합마취,관찰비교2조술중록알동용량,진통급기송효과,마취소성시간급병발증.결과 수술개시후0、5、10 min,B조적심솔、평균동맥압여A조상비명현증가(P<0.01).이호흡적억제정도칙A조저우B조.수술개시후5 min표현최위명현.수술개시후15 min칙2조각삼수접근기출마취후수평.진통효과:A조25례균위Ⅰ급;B조16례위Ⅰ급,9례위Ⅱ급;기육송이효과:A조25례균위우,B조11례위우,8례위량,6례위차.2조진통급기육송이효과비교,차이유통계학의의(P<0.01).A조록알동총량명현소우B조.A조무두통급척신경손해등증상,B조중유5례발생후경련;소성기A조2례조동,1례출현정신증상,1례구토.B조7례조동,4례출현정신증상,3례구토.결론 요마-경막외연합가록알동마취응용우소인하복급하지수술구유마취효과학절、전신마취약용량교소、술후소성쾌、불량반응교소등우점.
Objective To observe the effects of spinal-epidural anesthesia combined with ketemine anesthesia in pediatric surgery.Methods Fifty patients(ASA Ⅰ～Ⅱ)aged 1～5 years undergoing operation of abdomen or lower limbs were randomly divided into two groups:the Spinal-epidural anesthesia combined with ketamine anesthesia group(group A,n=25),ketamine intravenous anesthesia group(group B,n=25).Results The effect of anesthesia in group A was better than group B during the operation(P<0.05).The incidence of body movement and hrynx spasm was higher in group B(P<0.05).The quantity of ketamine was less in group A than that in group B.The recovery Was faster and more steadily in group A(P<0.05).Conclusions The Spinal-epidural Anesthesia combined with ketamine anesthesia used in operation of children can decrease the quantity of ketamine and reduce the uncomfortable response.Children's breath and circulation ale steady during the anesthesia and operation.
