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目的评价口服咪唑安定复合氯胺酮预防和消除儿童牙科畏惧症的镇静镇痛效果。方法 92例患儿随机分为口服咪唑安定0.5 mg/kg+氯胺酮5 mg/kg组(简记为MK组)和口服咪唑安定0.5 mg/kg组(简记为M组),每组各46例。记录给药前(T1)、给药30 min(T2)、手术结束5 min(T3)时的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2)和Ramsay镇静评分,记录术中呼吸抑制和低氧血症发生率及肢体活动情况,术后恶心呕吐发生率。结果 M组5例患儿术中有肢体活动,加局麻药阻滞后完成治疗。两组T2、T3的Ramsay镇静评分分别与T1比较,差异均有统计学意义(P<0.05);MK组和M组在T2时的Ramsay镇静评分分别为2.5±0.4和2.1±0.5,两组比较差异有统计学意义(P<0.05)。两组均无呼吸意外,术中及术后均无恶心、呕吐及低氧血症发生。结论口服咪唑安定复合氯胺酮在给药30 min后的镇静效果优于单服口服咪唑安定组,可以较好地预防和消除儿童牙科畏惧症。
Objective To evaluate the sedative and analgesic effect of oral midazolam combined with ketamine in preventing and eliminating dental fear of children. Methods Ninety-two children were randomized to receive oral administration of midazolam 0.5 mg / kg + ketamine 5 mg / kg (abbreviated as MK group) and oral midazolam 0.5 mg / kg group (abbreviated as M group), with 46 patients in each group . The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and Ramsay sedation score were recorded before administration (T1), administration at 30 min (T2) and at the end of 5 min Intraoperative respiratory depression and hypoxemia incidence and limb activity, postoperative nausea and vomiting. Results In the M group, 5 cases of children had physical activity during the operation. After the local anesthetic block was added, the treatment was completed. The Ramsay sedation scores of T2 and T3 were significantly higher than those of T1 (P <0.05), while the Ramsay sedation scores of MK and M were 2.5 ± 0.4 and 2.1 ± 0.5 at T2 respectively The difference was statistically significant (P <0.05). No respiratory accident in both groups, no nausea, vomiting and hypoxemia during and after operation. Conclusion The sedation of oral administration of midazolam combined with ketamine is superior to that of midazolam alone in 30 min after administration, which can prevent and eliminate dental fear of children better.