亚麻醉剂量氯胺酮-芬太尼辅助小儿区域麻醉临床观察(1)
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[摘要] 目的 分析观察小儿手术中亚麻醉剂量氯胺酮-芬太尼辅助的区域麻醉的临床效果。方法 2008年1月～2010年6月我院实施下肢和腹部手术的86例患儿中随机抽取20例患儿作为对照组采用单一氯胺酮麻醉，另66例作为观察组采用亚麻醉剂量氯胺酮-芬太尼辅助区域麻醉。结果 观察组患儿区域麻醉中的芬太尼用量、氯胺酮用量、氯胺酮追加次数、唤醒时间均远远低于对照组(P<0.05)；观察组患儿的心率、脉搏氧饱和度、呼吸频率均比对照组患儿显著降低(P<0.05)，平均动脉压也较对照组低；观察组未出现不良反应且肌松状况良好，对照组偶有不良反应，无肌松状况。结论 亚麻醉剂量氯胺酮芬太尼辅助的区域麻醉在小儿手术中具有明显优势。
[关键词] 亚麻醉剂量氯胺酮；芬太尼；小儿区域麻醉
[中图分类号] R726.1 [文献标识码] B [文章编号] 1673-9701(2011)33-61-02
Clinical Observation of Anesthesia Dose Ketamine-fentanyl Auxiliary Pediatric Regional Anesthesia
PAN Haibo
Shenzhen Municipal Longgang District Second People's Hospital，Shenzhen 518112，China
[Abstract] Objective To analyze the observed dose pediatric surgery，ketamine anesthesia fentanyl in Central Asia supporting the clinical effects of regional anesthesia. Methods From January 2008 to June 2010 in our hospital，86 cases with the lower limbs and abdominal surgery were randomly selected，20 patients as a control group were using a single ketamine anesthesia， and the other 66 cases as the observation group were treated with sub-anesthetic dose of ketamine - fentanyl assisted regional anesthesia. Results The regional anesthesia in children with fentanyl dosage，dosage of ketamine，ketamine additional times，wake-up time were far lower than the control group(P<0.05)；Observation group of children with heart rate，pulse oxygen saturation， respiratory frequency than the control group patients were significantly lower(P<0.05)；Mean arterial pressure was lower than the control group；observation group was no adverse reactions and muscle relaxants in good condition，occasional adverse reactions in control group and no muscle relaxant conditions. Conclusion The auxiliary sub-anesthetic dose of ketamine，fentanyl regional anesthesia in pediatric surgery has obvious advantages.
[Key words] The anesthesia dose ketamine；Fentanyl；Pediatric regional anesthesia
随着人类对自身机体健康水平要求的升高，对手术麻醉的要求已不再局限于减少术中和术后疼痛感以及麻醉对大脑的影响，现代麻醉还要求尽量减少麻醉剂量、不良反应、手术及唤醒时间等，尤其是小龄患儿，由于正处于身体发育时期，一般会尽量采取区域麻醉，但又因为其年龄幼小不懂配合使其手术区域麻醉要求和难度较高，以往的氯胺酮单一麻醉剂量大、不良反应多，以至于患儿的苏醒时间较长，我院2008年1月～2010年6月对部分需采用区域麻醉的小儿患者实施了亚麻醉剂量氯胺酮芬太尼的区域麻醉，效果较好，现报道如下。
1 资料与方法
1.1 一般资料
2008年1月～2010年6月我院共对86例患儿实施了下肢和腹部手术，其中男性46例，女性40例 ......
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