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目的:对单次骶管阻滞复合氯胺酮基础麻醉与全凭氯胺酮静脉麻醉在小儿下腹部手术的麻醉疗效进行观察和对比。方法:选择在我院2013年3月至2014年3月期间,在儿科住院的下腹部位将进行手术的患儿70例作为本次临床观察的研究对象。并根据麻醉方法的不同,将此70例患儿分为观察组和对照组,其中观察组与对照组患儿均为35例。对对照组患儿采用全凭氯胺酮静脉麻醉的方法,对观察组的患儿采用单次骶管阻滞复合氯胺酮基础麻醉的方法。对患儿麻醉前后的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SPO2)的变化程度进行观察,同时对于患儿的氯胺酮用量、手术时间以及在手术后的清醒时间等进行记录。结果:通过对观察组以及对照组两组患儿在手术中的HR观察可以发现,在手术中两组患儿的HR明显上升,手术后10min可以发现观察组患儿的HR要明显低于对照组患儿,与麻醉前的数据差异无统计学意义,手术后10min可以发现观察组患儿的MAP要明显低于对照组患儿,与麻醉前的数据差异具有统计学意义,且观察组没有患儿出现不良反应。结论:在小儿下腹部手术中,单次骶管阻滞复合氯胺酮基础麻醉与全凭氯胺酮静脉麻醉方法相比更具有优势,值得在临床上进行推广。
OBJECTIVE: To observe and compare the anesthetic effects of single caudal block with ketamine and all ketamine intravenous anesthesia in pediatric lower abdominal surgery. Methods: From March 2013 to March 2014 in our hospital, 70 cases of children who underwent surgery in the lower abdomen of pediatric hospital were selected as the object of this clinical observation. According to the different anesthesia methods, the 70 children were divided into observation group and control group, of which 35 cases in observation group and control group. The control group of children with ketamine intravenous anesthesia method alone, the observation group of children with a single sacral block combined ketamine basic anesthesia. The changes of MAP, HR and SPO2 in children before and after anesthesia were observed. Meanwhile, the dosage of ketamine, operation time and awake time after operation were observed recording. Results: HR observation of the two groups of children in the observation group and the control group can be found in the surgery in the two groups of children’s HR increased significantly, 10min after surgery can be found in the observation group children HR was significantly lower than the control There was no significant difference between pre-anesthesia data and pre-anesthesia data. After 10 minutes of surgery, the MAP in children in the observation group was significantly lower than that in the control group, and there was statistical difference between pre-anesthesia data and the observation group Adverse reactions in children. Conclusion: In the pediatric lower abdomen surgery, single caudal block combined ketamine basic anesthesia and ketamine intravenous anesthesia compared with all the more advantages, it is worth in the clinical promotion.