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目的对比观察氯胺酮复合丙泊酚和芬太尼用于小儿静脉麻醉与氯胺酮复合丙泊酚用于3～8岁患儿手术的临床麻醉效果及不良反应。方法选取60例ASAI～Ⅱ级,四肢骨折或腹部择期手术的3～8岁患儿,按麻醉方法的不同随机分为氯胺酮复合丙泊酚和芬太尼组(A组)和氯胺酮复合丙泊酚麻醉组(B组),记录术中生命体征及不良事件情况。术后记录恶心、呕吐等不适及疼痛评分。结果两组术中均无呼吸暂停等严重事件发生。手术开始及手术开始后各时段两组的生命体征差异均无统计学意义。两组术后不适发生无显著差异。与B组相比,A组术后清醒时间短,A组术后镇痛效果优于B组且减少氯胺酮用量。结论氯胺酮复合丙泊酚和芬太尼能够提供更平稳的镇静效果和镇痛效果,减轻不良反应的发生,同时明显缩短苏醒时间,是一种理想的麻醉方法。
Objective To compare the clinical effects and adverse reactions of ketamine combined with propofol and fentanyl in infantile intravenous anesthesia and ketamine combined with propofol for the treatment of children aged 3 to 8 years. Methods Sixty children aged 3-8 years old with ASAI ~ Ⅱ grade fracture or limb elective surgery were randomly divided into ketamine combined propofol and fentanyl group (group A) and ketamine compound prophylaxis Phenol anesthesia group (group B), the intraoperative vital signs and adverse events were recorded. Postoperative nausea, vomiting and other discomfort and pain score. Results There were no serious events such as apnea in the two groups. There was no significant difference in vital signs between the two groups at the beginning of the operation and after the operation was started. There was no significant difference between the two groups in postoperative discomfort. Compared with group B, group A had shorter postoperative awakening time, group A had better postoperative analgesia than group B, and decreased the amount of ketamine. Conclusions Ketamine combined with propofol and fentanyl can provide more stable sedative and analgesic effects, reduce the incidence of adverse reactions, and significantly shorten the recovery time, which is an ideal anesthetic method.