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目的:比较长托宁和阿托品作为小儿氯胺酮麻醉前用药的效果。方法:40例ASAI级3~6岁患儿,随机分为长托宁组和阿托品组,每组20例,均行氯胺酮静脉麻醉。监测患儿麻醉前后的心率(HR)、平均动脉压(MBP)和血氧饱和度(SpO2)以及口腔分泌物情况。结果:长托宁组给药后HR无明显变化,而静脉注射氯胺酮后则较基础值增加(P<0.05),长托宁组MBP仅于给予氯胺酮后5 min高于基础值(P<0.05);阿托品组给药10 min后MBP开始增高(P<0.05),并一直持续至手术结束。结论:长托宁对小儿患者血压和心率无明显影响,能有效抑制腺体分泌,用于小儿氯胺酮麻醉前用药比阿托品更具优势。
OBJECTIVES: To compare the effects of long-acting topiramate and atropine on pre-narcotic use of pediatric ketamine. Methods: Forty ASAI children aged 3 to 6 years old were randomly divided into two groups, the control group and the atropine group. Twenty patients in each group were anesthetized with ketamine. Heart rate (HR), mean arterial pressure (MBP) and oxygen saturation (SpO2) and oral secretions were monitored before and after anesthesia in children. RESULTS: The HR of the penehyclidine group did not change significantly after administration of ketamine, but increased significantly after intravenous injection of ketamine (P <0.05). MBP of the penehyclidine group was higher than baseline at 5 min after administration of ketamine (P <0.05) ). After a 10-min administration of atropine, MBP began to increase (P <0.05), and continued until the end of surgery. CONCLUSION: Penehyclidine has no significant effect on blood pressure and heart rate in pediatric patients, and can effectively inhibit the secretion of gland. It is more advantageous than the use of atropine before ketamine anesthesia in children.