国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2009年
4期
55-57
,共3页
刘平%陈匡东%王兴高%余清河%曹自华%廖容珍%谭丽蓉%黎葵英
劉平%陳劻東%王興高%餘清河%曹自華%廖容珍%譚麗蓉%黎葵英
류평%진광동%왕흥고%여청하%조자화%료용진%담려용%려규영
硬膜外%小儿手术%镇静%小剂量氟胺酮与咪达唑仑
硬膜外%小兒手術%鎮靜%小劑量氟胺酮與咪達唑崙
경막외%소인수술%진정%소제량불알동여미체서륜
Epidural%Pediatric operation%Sedation%Small dose of ketamine and midazolam
目的 对比观察小儿手术选用连续硬膜外麻醉时,静脉辅助麻醉用药的效果.方法 选择5～10岁可配合麻醉操作的患儿,行下腹部位以下部位择期手术60例,在硬膜外麻醉效果满意后,随机分为两组,各30例.Ⅰ组:选氯胺酮100mg和地西泮10mg混合,按氯胺酮2.5mg/kg单次静脉注射.Ⅱ组:选氯胺酮100mg和咪达唑仑5mg混合,按氯胺酮1mg/kg单次静脉注射.分组记录用药前、用药后1min、5min、15min及术毕5min小儿HR、BP、SpO2、RR值;记录手术时间、面罩给氧例数,追加用药例数、术毕5min苏醒例数和术毕5min小儿OAA/S评分.结果 两组术中镇静、抑制牵拉反应效果均满意.两组BP、HR、SpO2、RR均平稳;术毕5min两组OAA/S评分均为4～5分.结论 小剂量氟胺酮咪达唑仑同样对小儿循环系统和呼吸系统干扰轻,且用药量少,安全实用.
目的 對比觀察小兒手術選用連續硬膜外痳醉時,靜脈輔助痳醉用藥的效果.方法 選擇5～10歲可配閤痳醉操作的患兒,行下腹部位以下部位擇期手術60例,在硬膜外痳醉效果滿意後,隨機分為兩組,各30例.Ⅰ組:選氯胺酮100mg和地西泮10mg混閤,按氯胺酮2.5mg/kg單次靜脈註射.Ⅱ組:選氯胺酮100mg和咪達唑崙5mg混閤,按氯胺酮1mg/kg單次靜脈註射.分組記錄用藥前、用藥後1min、5min、15min及術畢5min小兒HR、BP、SpO2、RR值;記錄手術時間、麵罩給氧例數,追加用藥例數、術畢5min囌醒例數和術畢5min小兒OAA/S評分.結果 兩組術中鎮靜、抑製牽拉反應效果均滿意.兩組BP、HR、SpO2、RR均平穩;術畢5min兩組OAA/S評分均為4～5分.結論 小劑量氟胺酮咪達唑崙同樣對小兒循環繫統和呼吸繫統榦擾輕,且用藥量少,安全實用.
목적 대비관찰소인수술선용련속경막외마취시,정맥보조마취용약적효과.방법 선택5～10세가배합마취조작적환인,행하복부위이하부위택기수술60례,재경막외마취효과만의후,수궤분위량조,각30례.Ⅰ조:선록알동100mg화지서반10mg혼합,안록알동2.5mg/kg단차정맥주사.Ⅱ조:선록알동100mg화미체서륜5mg혼합,안록알동1mg/kg단차정맥주사.분조기록용약전、용약후1min、5min、15min급술필5min소인HR、BP、SpO2、RR치;기록수술시간、면조급양례수,추가용약례수、술필5min소성례수화술필5min소인OAA/S평분.결과 량조술중진정、억제견랍반응효과균만의.량조BP、HR、SpO2、RR균평은;술필5min량조OAA/S평분균위4～5분.결론 소제량불알동미체서륜동양대소인순배계통화호흡계통간우경,차용약량소,안전실용.
Objective To compare and observe the effects of intravenous subsidiary narcotic drugs when using continuous epidural anesthesia in pediatric operations. Methods Sixty cases of 5～10 years old children that are able to cope with anesthesia procedure are chosen as subjects, and these children patients are performed with selective operation in the position below hypogastric zone. As the effects of epidural anesthesia are satisfied, the children are randomly divided into 2 groups and each group contains 30 cases. The first group: 100mg of ketamine and 10mg of diazepam are mixed and the subjects are performed with single intravenous injection according to 2.5mg/kg of ketamine. The second group: 100mg of ketamine and 5mg of midazolam are mixed and the subjects are performed with single intravenous injection according to 1mg/kg of ketamine. HR, BP, SpO2 and RR values of the children in each group are recorded before the medication, 1min, 5min, 15min after medica-tion and 5min after operation; the operation time, the case number of mask oxygen inhalation, the case number of boost medication, the case number of analepsia and children OAA/S score 5min after operation are recorded. Results The effects of sedation and inhibition of traction reaction are satisfied in both groups; BP, HR, SpaO2, RR in both groups is stable; OAA/S score in both groups is 4～5 points 5min after operation. Conclusion Small dose of ketamine and midazolam have the same small interference on the circulation and respiration systems of the children, in addition, the drugs consumption are small and these drugs are safe and practical.
