【摘要】 目的 对比观察氯胺酮复合丙泊酚辅助骶管麻醉和常规氯胺酮麻醉用于小于6岁患儿腹部以下部位手术的临床效果。方法 60例小于6岁进行腹部以下部位择期手术的患儿按麻醉方法的不同随机分为常规麻醉组(氯胺酮组，K组)和氯胺酮复合丙泊酚辅助骶管麻醉组(KPS组)，观察麻醉前后平均动脉压(MAP)、心率(HR)、呼吸频率(R)、脉搏氧饱和度(SpO2)的变化程度以及术后清醒时间，术中及术后躁动、呕吐等不良反应的发生率。结果 K组与麻醉前及KPS组麻醉后相比平均动脉压(MAP)、心率(HR)显著增高(P<0.01)，呼吸频率(R)显著增快，而KPS组与麻醉前相比差异无显著性。与K组相比，KPS组术后清醒时间短，术中及术后躁动、呕吐等不良反应发生少(P<0.01)。结论 氯胺酮复合丙泊酚辅助骶管麻醉用于小儿腹部以下部位手术效果满意，呼吸循环更稳定，术后清醒快，其临床效果优于常规氯胺酮麻醉。

    【关键词】 骶管内麻醉；丙泊酚；氯胺酮

    The Clinical study of ketamine combined with propofol aided sacral anesthesia

    GU Shi-xian, CHANG Sheng-he,WANG Qing-bao.

    Anesthesia Department of Nanjing Jiangbei People's Hospital of South-East University,Nanjing 210048,China

    【Abstract】 Objective To compare the clinical effects of conventional anesthesia (ketamine) and ketamine combined with propofol aided sacral anesthesia in pediatric patients who undergoing operations below belly.Methods Sixty pediatric patients (<6 years) who undergoing elective operations below belly were randomly allocated to either a conventional anesthesia group (ketamine,group K,n=30) or ketamine combined with propofol aided sacral anesthesia (group KPS,n=30). The variation of peri-anesthesia mean arterial pressure(MAP), heart rate(HR), respiration rate(RR), pulse oxygen saturation (SpO2)were tested and recorded. The wake time,the peri-operative incidence of restlessness and vomit were observed. Results The post-anesthesia MAP (P<0.01), HR (P<0.01), RR (P<0.05) in group K were significantly increased than its pre-anesthesia level and those in group KPS. While there were no significant difference of above parameters in group KPS than its pre-anesthesia level. The wake time, peri-operative incidence of restlessness and vomit in group KPS were remarkably shorter or lower than those in group K (P<0.01).Conclusion With stable respiration and circulation maintenance, shorter wake time, peri-operative incidence of restlessness and vomit in group KPS has better clinical effect than those in group K. ......