丙泊酚复合不同剂量氯胺酮用于小儿短小手术的疗效观察

摘要

目的：观察丙泊酚复合不同剂量氯胺酮用于小儿短小手术的麻醉效果及不良反应。方法：将287例行短小手术的患儿分为A组(2 mg/kg丙泊酚+2 mg/kg氯胺酮)、B组(2 mg/kg丙泊酚+3 mg/kg氯胺酮)和C组(2 mg/kg丙泊酚+4 mg/kg氯胺酮)，分别观察患儿的一般情况，麻醉维持时间、追加次数、单位时间用药量、术中体动反应、苏醒时间以及并发症的发生情况。结果：比较3组患儿的平均年龄、体重、手术时间以及术中呼吸频率和SpO2等一般情况，差异无统计学意义(P＞0.05)；与A组比较，B组麻醉维持时间、追加氯胺酮的次数、单位时间氯胺酮用量、术中体动反应及术后苏醒时间等麻醉效果变化差异无统计学意义(P＞0.05)，但C组患儿麻醉维持时间、追加次数、单位时间用药量、术中体动反应和苏醒时间均优于其他两组(P＜0.05)；3组并发症发生率经统计学分析差异无统计学意义(P＞0.05)。结论：4 mg/kg氯胺酮用于小儿短小手术可明显延长作用时间，减少体动反应，缩短苏醒时间，明显改善麻醉效果，且无明显不良反应。%Objective:To explore the anesthesia effect and adverse reaction of propofol combined with different dose of ketamine for children with short operation.Methods:287 patients with short operation were divided into A group(2 mg/kg propofol+2 mg/kg ketamine),B group(2 mg/kg propofol + 3 mg/kg ketamine) and C group(2 mg/kg propofol + 4 mg/kg ketamine).We observed the general situation,maintenance of anesthesia time,additional times,unit time dosage,body movement during operation,recovery time and complications.Results:We compared the average age,body weight,respiratory frequency during operation and operation time and SpO2 of the three groups,and there was no significant difference(P>0.05);compared with group A,in group B,anesthesia duration,the number of additional ketamine,unit time dosage of ketamine,intraoperative body movement and postoperative recovery time had no significant difference(P>0.05),but in group C,anesthesia duration,additional times,unit time dosage,surgery body dynamic response and recovery time were better than the other two groups(P<0.05);after statistical analysis,three groups of complication rate were no significant difference(P>0.05).Conclusion:4 mg/kg ketamine in children with short operation can obviously prolong the action time,reduce the body movement,shorten the time of consciousness recovery,significantly improve the anesthetic effect,and there was no obvious adverse reactions.