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目的:分析亚麻醉剂量氯胺酮—芬太尼辅助小儿区域麻醉临床效果。方法:对110例四肢和腹部手术患儿相关临床资料进行分析,随机将患儿分为对照组和观察组,对照组55例,观察组55例,对照组患儿进行单一氯胺酮麻醉以后依据患儿实际病情进行常规手术治疗,观察组患儿中下肢和腹部手术进行亚麻醉剂量氯胺酮联合芬太尼辅助区域麻醉,上肢手术患儿实施氯胺酮亚麻醉剂量+神经阻滞芬太尼进行辅助麻醉。结果:观察组患儿芬太尼和氯胺酮使用量分别22.31±6.29μg和53.28±12.20μg,对照组的使用量分别是38.87±16.23μg和16.63±34.81μg,两组氯胺酮和芬太尼的使用量和唤醒时间有明显的统计学差异,P<0.05。手术时间分别为93.77±32.31 min和91.08±26.34 min,差异无统计学意义,P>0.05。结论:亚麻醉剂量氯胺酮—芬太尼进行区域麻醉有较强的镇痛能力,对于小儿麻醉效果尤佳,麻醉剂用量以及唤醒时间显著减少,氯胺酮有血压升高作用,而芬太尼血压下降可能性又特别高,两者恰巧抵消,使患儿麻醉后生存质量显著提高,可在临床治疗中推广。
Objective: To analyze the clinical effect of sub-anesthetic ketamine-fentanyl-assisted pediatric regional anesthesia. Methods: The clinical data of 110 children with limbs and abdomen surgery were analyzed. The children were randomly divided into control group and observation group. 55 cases in control group and 55 cases in observation group were treated with ketamine alone. The actual condition of the children were treated by conventional surgery. The anesthesia of anesthesia with anesthetic ketamine and fentanyl was performed in the middle and lower extremities and abdomen in the observation group. The anesthetic dose of ketamine and nerve block fentanyl were used in the upper limb surgery. Results: The dosage of fentanyl and ketamine were 22.31 ± 6.29μg and 53.28 ± 12.20μg in the observation group and 38.87 ± 16.23μg and 16.63 ± 34.81μg in the control group, respectively. The use of ketamine and fentanyl in the two groups There was a statistically significant difference between the amount and awakening time, P <0.05. The operative time was 93.77 ± 32.31 min and 91.08 ± 26.34 min, respectively, with no significant difference (P> 0.05). CONCLUSIONS: The sub-anesthetic dose of ketamine-fentanyl for regional anesthesia has a strong analgesic effect, especially for pediatric anesthesia. The anesthetic dosage and wake-up time are significantly reduced, and ketamine has the effect of raising blood pressure. However, the decrease of fentanyl blood pressure may be Sexual and particularly high, the two happen to offset, so that children’s quality of life after anesthesia significantly improved, can be promoted in clinical treatment.