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目的探讨臂丛神经阻滞复合丙泊酚或丙泊酚合用氯胺酮用于小儿上肢手术的可行性及效果。方法 90例行上肢手术患儿随机分为三组,行臂丛神经阻滞后分别复合丙泊酚持续泵入、丙泊酚+氯胺酮持续泵入、间断静脉注射氯胺酮,观察患儿术中生命征、体动、麻醉效果及术毕清醒时间。结果臂丛阻滞复合丙泊酚或丙泊酚+氯胺酮组术中HR均明显低于静脉注射氯胺酮组,术中麻醉效果均显著优于静脉注射氯胺酮组,差异有统计学意义(P<0.01);术后苏醒时间也明显短于后者。结论臂丛神经阻滞复合丙泊酚或丙泊酚合用氯胺酮静脉持续泵入法用于小儿上肢手术具有操作简单,术中镇痛、镇静效果完善,生命征平稳、麻醉效果满意、术后清醒迅速等优点,是一种安全可行的小儿麻醉方法。
Objective To investigate the feasibility and effect of brachial plexus block combined with propofol or propofol combined with ketamine for pediatric upper limb surgery. Methods Totally 90 children undergoing upper extremity operation were randomly divided into three groups. After continuous brachial plexus block, propofol was continuously pumped, continuous infusion of propofol + ketamine and intermittent intravenous injection of ketamine were performed to observe the intraoperative life Zheng, physical activity, anesthesia and wake up time. Results The intraoperative HR of brachial plexus block propofol or propofol + ketamine group was significantly lower than that of intravenous ketamine group. The intraoperative anesthetic effect was significantly better than that of intravenous ketamine group (P <0.01) ); Postoperative recovery time is also significantly shorter than the latter. Conclusions Brachial plexus block combined with propofol or propofol combined with ketamine intravenous continuous pump method for pediatric upper limb surgery has the advantages of simple operation, intraoperative analgesia, complete sedation, stable vital signs, satisfactory anesthetic effect and postoperative wakefulness Rapid, etc., is a safe and feasible method of pediatric anesthesia.