摘要:目的：比较氯胺酮复合不同镇静麻醉药用于小儿静脉麻醉的效果及优缺点。方法：86例择期体表手术的患儿，年龄3～6岁,随机分为四组，氯胺酮复合羟丁酸钠(H)组20例；氯胺酮复合咪唑安定(M)组21例；复合异丙酚(P)组25例；复合氟哌利多(D)组20例。术中监测ECG、血压、SpO2 ，记录心率、血压变化、手术时间、每小时体动次数、术后清醒时间。结果：四组患儿均能顺利完成手术，术中呼吸循环平稳。(H)组静注羟丁酸钠后心率明显减慢，但对血压及SpO2影响不大。术后清醒(P)组最快平均22±7.2min，(M)组平均42±11.5min，(D)组及(H)组最慢，分别为63±15.6min及72±18.3min。结论：上述四种组合用药方法均能满足手术要求，其中氯胺酮、异丙酚复合麻醉效果满意，副作用较少，可控性强，麻醉后恢复快，明显优于其它复合用药方法。

    关键词： 小儿麻醉; 氯胺酮; 异丙酚

    A Clinical Comparison of Pediatric Anaesthesia with Ketamine-propofol in Different Combinations

    LIAO Li-xing, CHEN Cong

    (The Central Hospital of Guangdong Province Agricultural Reclamation, Guangdong Zhanjiang 524002, China)

    Abstract: Objective: To study the effects of ketamine combined with different Phenobarbitals in pediatric intravenous anaesthesia. Methods: 86 cases of children who underwent operation were divided into four groups. The age was 3～6 years old . Group H (20 cases), Group M (21 cases), Group P (25 cases), Groups D (20cases) all received ketamine with sodium gamma hydroxyburate or midazolam, propofol and droperidol respectively. ECG, BP, SpO2, HR, the time of operation and postoperative consciousness recovery were monitored. Results: All cases tolerated the operations successfully with stable cardiorespiratory function. HR was obviously decreased but not much change in BP and SpO2 after intravenous sodium gamma hydroxybuthyrate in Group H. postoperative consciousness recovery was the most rapid in Group P with a mean of 22±7.2 minutes, Group M recovery time was 42±11.5 minutes, the slowest were groups D and H requiring 63±15.6 and 72±18.3 minutes respectively. Conclusion: All the four methods can satisfy the requirements for surgery. The anaesthetic combination of ketamine with propofol is distinctly better than the others with better anaesthesia, fewer side-effects, more easily controlled and faster recovery. ......