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目的观察氯胺酮复合丙泊酚的静脉麻醉,非气管插管用于小儿腹股沟疝手术的麻醉效果及对循环、呼吸的影响。方法拟行小儿腹股沟疝手术患儿498例,年龄3～8岁,以氯胺酮1.5～2mg/kg静脉基础麻醉,然后以氯胺酮25～30μg·kg-1.min-1、丙泊酚1.5～2mg·kg-1.h-1持续静脉泵注维持,面罩给氧。监测收缩压、舒张压、平均动脉压、心率、脉搏氧饱和度和心电图。结果患儿术中安静476例(95.58%),出现短暂肢体轻微扭动22例(4.42%);麻醉诱导后及术中血压、心率和呼吸频率平稳,无呼吸暂停;术毕苏醒时间(15.24±10.08)min;苏醒期轻微躁动16例(3.21%),恶心12例(2.41%)。结论氯胺酮复合丙泊酚持续泵注静脉麻醉用于小儿腹股沟疝手术的镇静、镇痛效果满意,对血压、心率和呼吸频率影响小。
Objective To observe the effects of ketamine combined with propofol in venous anesthesia and non-tracheal intubation for pediatric inguinal hernia and its effects on circulation and respiration. Methods 498 pediatric patients undergoing inguinal hernia surgery were enrolled in this study. The patients were aged from 3 to 8 years and were initially anesthetized with ketamine 1.5-2 mg / kg intravenously. Then, ketamine 25-30 μg · kg-1.min-1, propofol 1.5-2 mg · Kg-1.h-1 continuous intravenous maintenance, mask oxygen. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, pulse oximetry, and electrocardiogram were monitored. Results A total of 476 patients (95.58%) were quiet during surgery, 22 cases (4.42%) had slight twisting of short limbs, and the blood pressure, heart rate and respiratory rate were steady without apnea after induction of anesthesia. ± 10.08) min. There were 16 cases (3.21%) with mild agitation and 12 cases (2.41%) with nausea. Conclusions Ketamine combined with propofol continuously pumped intravenous anesthesia for pediatric inguinal hernia surgery had satisfactory sedative and analgesic effects with little effect on blood pressure, heart rate and respiratory rate.