摘要
目的观察臂丛神经阻滞复合氯胺酮麻醉在小儿上肢手术中的应用效果。方法选择单侧上肢骨折行切开内固定手术的患儿60例,随机分为治疗组30例和对照组30例:治疗组患儿采用臂丛神经阻滞麻醉,术中给予氯胺酮强化;对照组采用氯胺酮复合咪唑安定全身麻醉。观察手术中HR、SpO2、MAP的变化;观察麻醉期间氯胺酮的用量及术毕神志恢复情况。结果治疗组患儿术后立即清醒,术后1小时哭闹和术后2小时哭闹的人数均多于对照组的患儿,(P<0.05)。治疗组氯胺酮总用量明显小于对照组(P<0.05);治疗组HR及MAP增高,SpO2下降的人数明显小于对照组(P<0.05)。结论臂丛神经阻滞复合氯胺酮麻醉效果完善,安全系数高,全麻药用量小,是小儿上肢手术较为理想的麻醉方法。
Objective To observe the anesthetic effect of brachial plexus block combined with ketamine anesthesia in upper extremity operation of preschool children. Methods Totally 60 preschool children of unilateral upper extremity fracture treated by open reduction and internal fixation were randomly divided into two groups, treatment group （n = 30） ： braehial plexus block, ketamine was injected in operation to strengthen the anesthetic effect; Control group （n = 30） ： general anesthesia using ketamine combined with midazolam. Observed the changes of HR, SpO2, MAP, the total dosage of ketamine during anesthesia and awareness after operation. Results The children of treatment group awaked immediately after operation, the number of cry and scream children of treatment group in 1 hour and 2 hours after opera-tion was more than that of control group （ P 〈 0. 05 ）. The total dosage of ketamine of treatment group was less than that of the control group （P 〈 0. 05 ）. The number of children whose HR, MAP rised and SpO2 decreased was less than that of the control group （P 〈 0. 05 ）. Conclusions Brachial plexus block combined with ketamine anesthesia has perfect anesthetic effect, high safety coefficient, low dosage of general anesthetics, and the method is a fairly ideal type of anes- thesia for upper extremity operation of preschool children.
出处
《医药论坛杂志》
2012年第3期51-52,55,共3页
Journal of Medical Forum
关键词
小儿上肢手术
臂丛神经阻滞
氯胺酮
咪唑安定
Upper extremity operation of preschool children
Brachial plexus block
Ketamine
Midazolam
