七氟烷联合氯胺酮复合麻醉用于小儿腹股沟斜疝手术的效果及安全性

摘要

Objective To investigate effect and safety of the seven sevoflurane combined with ketamine anesthesiaforanesthesiapediatricinguinalherniasurgery.Methods 102caseswithindirectinguinalhernia were select ed from May 2012 to April 2014 in our hospital during undergoing high ligation of hernial sac were randomly divided into observation group and control group,51 cases in each group.The observation group take seven isoflurane anesthesia combined with ketamine intravenous anesthesia ,the control group took ketamine intravenous anesthesia.The change of heart rate,respiration,mean arterial pressure and oxygen sat-uration of blood were observed before and after treatment,ketamine dosage,postoperative recovery time and postoperative recovery time, the incidence of complications of anesthesia of two groups were com-pared.Results Heart rate,respiration,mean arterial pressure and oxygen saturation in the observation group were not obvious fluctuation,the control group after treatment with time changes showed increased heart rate , respiration,mean arterial pressure and blood oxygen saturation decreased trend, each index at different groups,different time points and groups・ different time points had statistically siynificant diference ( P <0.01).The dosage of ketamine was significantly lower in observation group than that in control group[(59 ± 21) mg vs (92 ±37) mg,P<0.05],postoperative recovery time and postoperative awake time were shorter than those in control group[(22 ±4) min vs (34 ±8) min,(29 ±6) min vs (59 ±13) min,P<0.05];agitation,nausea,vomiting,respiratory inhibition rates in observation group were 11.8%(6/51),17.6%(10/51) and 5.9%(3/51),were significantly lower than those in the control group 29.4%(15/51), 35.3%(18/51) and 19.2%(10/51) (P <0.05).Conclusion Seven sevoflurane combined with ket-amine anesthesia for pediatric inguinal hernia surgery on respiratory and circulatory disturbance of smaller , faster postoperative recovery, effectively reduce the occurrence of complications from anesthesia , and can reduce the dosage of ketamine,is a better anesthetic effect and safety of higher anesthetic regimen.%目的：探讨七氟烷联合氯胺酮复合麻醉用于小儿腹股沟斜疝手术的麻醉效果及安全性。方法选择2012年5月至2014年4月在涟水县人民医院拟行疝囊高位结扎术治疗的腹股沟斜疝患儿102例，按照随机数字表法分成观察组和对照组，每组51例。观察组采取七氟烷吸入麻醉联合氯胺酮静脉麻醉，对照组采取氯胺酮静脉麻醉。观察两组患儿用药前后心率、呼吸、平均动脉压、血氧饱和度的变化情况，比较两组患儿氯胺酮用量、术后苏醒时间及术后清醒时间，并比较两组患儿麻醉并发症发生率。结果观察组用药后5 min及手术开始时心率、呼吸、平均动脉压及血氧饱和度相对稳定，对照组用药后随时间变化呈心率增快、呼吸减慢、平均动脉压升高及血氧饱和度下降的趋势，两组各指标组间、不同时点间、组间和不同时点间交互作用差异均有统计学意义（ P＜0．01）；观察组氯胺酮用量显著少于对照组[（59±21） mg 比（92±37） mg，P＜0．05]，术后苏醒时间及术后清醒时间显著短于对照组[（22±4） min 比（34±8） min，（29±6） min 比（59±13） min，P＜0．01]；观察组躁动，恶心、呕吐，呼吸抑制发生率分别为11．8％（6／51）、17．6％（10／51）及5．9％（13／51），均明显低于对照组的29．4％（15／51）、35．3％（18／51）及19．2％（10／51）（P＜0．05）。结论七氟烷联合氯胺酮复合麻醉用于小儿腹股沟斜疝手术对呼吸、循环的干扰较小，术后苏醒快，有效降低麻醉并发症的发生，且可以减少氯胺酮用量，是一种麻醉效果好且安全性较高的麻醉用药方案。