摘要：目的:对比观察单纯应用氯胺酮与氯胺酮复合力月西进行小儿中小型手术麻醉的临床效果及安全性。方法：选择40例ASI Ⅰ～Ⅱ级中小型小儿手术患者，随机分为两组。观察组氯胺酮和力月西联合应用(K.L组)对照组单纯使用氯胺酮(K组)。观察麻醉前及麻醉后5 min、10min、15min各时点患儿心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、血氧饱和度(SPO2)、呼吸末二氧化碳分压(PETCO2)以及清醒时间、不良反应等。结果：K组麻醉后AMP升高、HR增快，与麻醉前相比P<0.01。K.L组AMP升高、HR增快，与麻醉前比较，差异无显著性，P>0.05。两组呼吸频率均减慢。两组PETCO2与麻醉前相比，P<0.05。SPO2虽然有变化，但在临床允许的安全范围内，麻醉前后相比无显著差异。术后不良反应烦躁、哭闹，K组与K.L比较，P<0.05，差异显著。结论:氯胺酮和力月西联合应用于小儿中小手术的麻醉对小儿血流动力学和呼吸影响较小，是方便而安全的小儿麻醉方法，且较单纯应用氯胺酮更具优势。

    关键词：氯胺酮；力月西；小儿静脉麻醉

    The Clinical Observation on Pediatric Anesthesia with Ketamine Hydrochloride Combined With Midazdam

    CAO Zi-hua, YU Qing-he, LIU Ping, et al

    (Chang’an Hospital in Dongguan City,Guangdong Dongguan 523843,China)

    Abstract: Objective: Observing on the clinical effects and safety of pediatric anesthesia in small and medium operations by comparing single ketamine hydrochloride with ketamine hydrochloride combined with midazdam. Method: Forty ASI Ⅰ～Ⅱ pediatric patients for small and medium operations were selected and divided into two groups at random. The observation group was applied with ketamine hydrochloride combined with midazdam, and the control group with single ketamine hydrochloride. The observed contents including heart rate (HR), respiratory rate (RR), mean blood pressure (MAP), blood oxygen saturation (SPO2), end-tidal CO2 pressure (PETCO2), consciousness time and side effects et al, were observed at time points of 5 minutes, 10 minutes, and 15 minutes prior to anesthesia and post-anesthesia, respectively. Result： In group K, AMP and HR increased after anesthesia, by comparison with those before anesthesia P value was less than 0.01(P <0.01). In group K.L, AMP and HR increased, by comparison with those before anesthesia there was no significance (P>0.05). Respiratory rates all decreased in two groups. PETCO2 of two groups were compared with those before anesthesia, respectively, P values were less than 0.05 (P <0.05). Although SPO2 changed, it ranged in a safe limitation which was permitted clinically, and there was no significant difference of SPO2 before anesthesia compared with post-anesthesia. The post-operative side effects including dysphoria and blubbering had a significant difference ( P<0.05) by comparison of group K with group K.L. Conclusion： Ketamine hydrochloride combined with midazdam that were applied for pediatric anesthesia in small and medium operations had a little influence on hemodynamics and respiration, so it was a safe and convenient method for pediatric anesthesia, and had much advantage over utilization of single ketamine hydrochloride. ......