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目的比较喉罩-七氟烷辅助局部麻醉(0.125%利多卡因)与氯胺酮静脉麻醉在小儿短小手术中的麻醉效果。方法选择60例ASAⅠ～Ⅱ级,3～7岁择期行小儿小儿斜疝高位结扎术和包皮环切术患儿,随机分为喉罩-七氟烷-局麻组(A组),与氯胺酮静脉全麻组(B组)。记录麻醉前(T0)、切皮前(T1)、切皮后1min(T2)、30min(T3)、术毕(T4)的MAP与HR。观察术后患儿苏醒时间,术中术后镇痛效果。结果两组术中镇痛效果均佳,差异无统计学意义,术后A组有中长效局麻药作用患儿视觉模拟评分明显低于B组(P<0.05)。与A组相比B组全程MAP升高、HR增快(P<0.05),苏醒时间延长(P<0.05)。结论喉罩-七氟烷辅助局麻(0.125%利多卡因)在小儿短小手术的麻醉优于氯胺酮静脉麻醉。
Objective To compare the anesthetic effects of laryngeal mask-sevoflurane-assisted local anesthesia (0.125% lidocaine) and ketamine intravenous anesthesia in short pediatric surgery. Methods Sixty children with ASA Ⅰ ~ Ⅱ and 3-7 years old undergoing elective lumbar hiatus and circumcision were randomly divided into laryngeal mask-sevoflurane-local anesthesia group (A group) and ketamine Venous general anesthesia group (B group). The MAP and HR before anesthesia (T0), before incision (T1), 1 minute after skin incision (T2), 30 minutes (T3) and operation (T4) were recorded. Postoperative recovery time, postoperative analgesia effect were observed. Results The analgesic effect was good in both groups. There was no significant difference between the two groups. The visual analogue score of group A with moderate-to-long-effect local anesthetic effect was significantly lower than that of group B (P <0.05). Compared with group A, the MAP in group B increased, HR increased (P <0.05), and recovery time prolonged (P <0.05). Conclusions Laryngeal mask-sevoflurane-assisted local anesthesia (0.125% lidocaine) is superior to ketamine intravenous anesthesia in short pediatric surgery.