CAJ | 학술논문

目的研究咪唑安定复合氯胺酮肌注或口服用于小儿基础麻醉的可能性。方法 80例1～8岁、ASAⅠ～Ⅱ级的患儿随机等分成四组：A组，肌注氯胺酮6mg／kg；B组，肌注氯胺酮4mg／kg＋口服咪唑安定0.2mg／kg；C组，口服氯胺酮5mg／kg＋咪唑安定0.5mg／kg；D组，口服咪唑安定0.7mg／kg。观察各组麻醉诱导效果、循环呼吸变化及不良反应。结果（1）B组与A组相比，起效更快，术中不良反应发生率更低（P＜0.05），而麻醉诱导效果无明显差异（P＞0.05）；（2）C组与A组相比，小儿更为合作（P＜0.01），HR增加不明显（P＞0.05），但起效更慢（P＜0.05），镇静程度不如后者（P＜0.05），但80％的患儿尚能与父母分离。结论咪唑安定复合氯胺酮肌注用于小儿麻醉诱导要优于单纯肌注氯胺酮，而咪唑安定复合氯胺酮口服仍不失为一种可行的诱导方法。
목적 연구미서안정복합록알동기주혹구복용우소인기출마취적가능성。방법 80례1～8세、ASAⅠ～Ⅱ급적환인수궤등분성사조：A조，기주록알동6mg／kg；B조，기주록알동4mg／kg＋구복미서안정0.2mg／kg；C조，구복록알동5mg／kg＋미서안정0.5mg／kg；D조，구복미서안정0.7mg／kg。관찰각조마취유도효과、순배호흡변화급불량반응。결과 （1）B조여A조상비，기효경쾌，술중불량반응발생솔경저（P＜0.05），이마취유도효과무명현차이（P＞0.05）；（2）C조여A조상비，소인경위합작（P＜0.01），HR증가불명현（P＞0.05），단기효경만（P＜0.05），진정정도불여후자（P＜0.05），단80％적환인상능여부모분리。결론 미서안정복합록알동기주용우소인마취유도요우우단순기주록알동，이미서안정복합록알동구복잉불실위일충가행적유도방법。
Objective To investigate the possibility of muscular injection ororal administration of midazolam combined with ketamine for the induction in children．Methods 80 children，aged 1 to 8，ASAgrades Ⅰ－Ⅱ，were divided randomly into four groups：group A， ketamine 6mg／kg im，group B，ketamine 4mg／kg ＋midazolam 0.2mg／kg im， group C，ketamine 5mg／kg ＋midazolam 0.5mg／kg po，group D，midazolam 0.7mg／kg po． The efficacy of anesthsia induction，hemodynamic and respiratory changes and side effects of the drugs administered were observed．Results （1）Compared to group A，group B experienced faster onset and fewer side effects （P＜0.05），while the efficacy of induction had no significant difference （P＞0.05）．（2）Compared to group A，children in group C could cooperate better with out obvious heart-rate increase （P＞0.05），but experienced slower onset and worse induction quality （P＜0.05）．80％ of patients in group C could separate from their parents．Conclusion Intramuscular injection of midazolam combined with ketamine is a better method than ketamine im alone for basic anesthesia in child．Oral administration of midazolam combined with ketamine is still an alternative method．