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目的比较小剂量氯胺酮-丙泊酚加臂丛神经阻滞与氯胺酮-丙泊酚静脉麻醉用于患儿断指再植术的麻醉效果与安全性。方法急诊断指再植术患儿80例,随机均分为两组。A组为氯胺酮-丙泊酚加臂丛神经阻滞;B组为氯胺酮-丙泊酚静脉麻醉。记录手术前后心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO2)、呼吸频率(RR)变化,评价麻醉效果以及苏醒期反应。结果术中,B组MAP和HR明显高于A组(P<0.05),B组的SpO2和RR值明显低于A组(P<0.05);A组氯胺酮、丙泊酚用量明显少于B组(P<0.01);术后A组苏醒较快且平稳,苏醒期精神症状少(P<0.01)。结论小剂量氯胺酮-丙泊酚加臂丛神经阻滞应用于患儿断指再植术麻醉效果好,不良反应少。
Objective To compare the anesthetic effect and safety of low dose ketamine-propofol plus brachial plexus block with ketamine-propofol intravenous anesthesia in severed finger replantation in children. Methods Eighty children with replantation of severed finger were randomly divided into two groups. Group A was ketamine-propofol plus brachial plexus block; Group B was ketamine-propofol intravenous anesthesia. The heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2) and respiratory rate (RR) were recorded before and after surgery to evaluate the effects of anesthesia and awakening reaction. Results The MAP and HR in group B were significantly higher than those in group A (P <0.05), and the values of SpO2 and RR in group B were significantly lower than those in group A (P <0.05). The dosage of ketamine and propofol in group B was significantly less than that in group B (P <0.01). After the operation, the awakening of group A was faster and stable, with less mental symptoms during recovery (P <0.01). Conclusion Low dose ketamine - propofol combined with brachial plexus block in replantation of severed finger in children has better anesthetic effect and less adverse reactions.