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目的:研究氯胺酮复合骶管麻醉在小儿下腹部手术中的疗效与安全性等。方法:两组患儿手术前半个小时进行肌内注射阿托品0.02mg/Kg,半小时后再注射氯胺酮5mg/kg,在患儿入睡后,开放其外周静脉,静脉注射地塞米松2mg。对照组与观察组均进行静脉注射氯胺酮2mg/kg和咪达挫仑0.2mg/kg。观察组患儿行骶管麻醉,单次注射1%利多卡因,手术过程中可根据患儿对手术的刺激反应酌情追加氯胺酮。结果:观察组患儿手术中HR、MAP变化较小,对照组患儿HR、MAP的波动较大,SpO2均无较大差别,较稳定。观察组明显使用氯胺酮量少,清醒也较快,不良反应较少。结论:氯胺酮复合骶管麻醉用药量少,不良反应减少,患儿术中管理方便,术后清醒较快,在小儿下腹部手术中效果显著,有临床推广价值。
Objective: To study the efficacy and safety of ketamine combined caudal anesthesia in pediatric lower abdominal surgery. Methods: Two groups of children received intramuscular injection of atropine 0.02 mg / Kg half an hour prior to surgery. After half an hour, ketamine 5 mg / kg was injected. After falling asleep, their peripheral veins were opened and dexamethasone 2 mg intravenously. The control group and the observation group were given intravenous ketamine 2mg / midazolam 0.2mg / kg. The observation group received caudal caudal anesthesia and a single injection of 1% lidocaine. During the operation, ketamine could be added according to the stimulation of the operation of the child as appropriate. Results: The changes of HR and MAP in the observation group were small. The fluctuation of HR and MAP in the control group was relatively large. There was no significant difference between the two groups, which was stable. Obviously the observation group used less ketamine, awake faster, fewer adverse reactions. CONCLUSION: Ketamine combined with caudal anesthesia has less dosage and adverse reactions. It is convenient for operation in children and awake quickly after operation. It has significant effect in pediatric lower abdominal surgery and has clinical value of popularization.