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神经阻滞复合氯胺酮应用于小儿手术的观察(1)
http://www.100md.com 2012年1月5日 黄建华 胡春华
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     [摘要] 目的 评价臂丛神经阻滞复合氯胺酮麻醉应用于小儿上肢手术的有效性及安全性。 方法 60例上肢手术患儿随机分为两组:A组为臂丛神经阻滞复合氯胺酮麻醉组,B组为单纯氯胺酮麻醉组。观察两组患儿术前、切皮时、术毕之SBP、DBP、HR、RR、SpO2;氯胺酮的用量;清醒时间(手术结束至患儿睁眼、能应答之时间);术后恶心、呕吐、躁动、哭闹等发生情况。 结果 B组切皮时SBP、DBP、HR明显高于基础值(P<0.05),也明显高于A组同时点(P<0.05)。氯胺酮用量A组明显少于B组(P<0.05),术毕清醒时间A组明显短于B组(P<0.05)。术后躁动及恶心、呕吐B组均明显多于A组(P<0.05)。 结论 臂丛神经阻滞复合氯胺酮麻醉应用于小儿上肢手术是有效的和安全的,不仅可减少术中氯胺酮用量从而减少其不良反应、加快患儿苏醒,而且可降低术后躁动及恶心、呕吐的发生率。

    [关键词] 臂丛神经阻滞; 氯胺酮;静脉麻醉;手术

    [中图分类号] R614.2+4 [文献标识码] B [文章编号] 1673-9701(2012)01-094-02

    Brachial plexus block combined with ketamine intravenous anesthesia in pediatric surgery

    HUANG Jianhua1 HU Chunhua2

    1.Department of Anesthesiology, the People′s No.3 Hospital of Hangzhou Xiaoshanin Zhejiang Province, Hangzhou 311251, China;2.Department of Pediatrics, the People′s No. 3 Hospital of Hangzhou Xiaoshan in Zhejiang Province, Hangzhou 311251, China

    [Abstract] Objective To evaluate the availability and safety of brachial plexus block combined with ketamine intravenous anesthesia in pediatric upper extremity surgery. Methods All of 60 routine upperextremity surgery were randomly divided into two groups: brachial plexus block combined with ketamine intravenous anesthesia group (group A), pure ketamine intravenous anesthesia group (group B). Observed the SBP, DBP, HR, RR, SpO2 of preoperation, cut skin, the end of operation, and observed the dosage of ketamine , safe consciousness time, and nausea, vomit, dysphoria, cry and scream after operation. Results When cut skin the SBP, DBP, HR of group B were significantly higher than group A (P<0.05); Ketamine dosage in group A was less than group B (P<0.05); Group A awaked faster than group B (P<0.05); The adverse events (body dysphoria, nausea and vomiting) in group A were significantly fewer than group A (P<0.05). Conclusion Brachial plexus block combined with ketamine intravenous anesthesia in pediatric upper extremity surgery is efficient and safe. This method could reduce ketamine dosage in order to reduce adverse reaction, and could accelerate vivification, decrease incidence of nausea, vomit, dysphoria ......

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