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目的对比观察两种不同麻醉方法在小儿下腹部浅表手术中的应用效果,探讨一种较为理想的小儿麻醉方法。方法选择小儿下腹部浅表手术40例,随机分成A和B两组,每组20例,A组为:氯胺酮-咪唑安定静脉复合麻醉;B组为:氯胺酮-咪唑安定静脉复合加单次硬膜外腔阻滞麻醉;各组患者对照麻醉效果评级标准进行观察评定。结果B组麻醉效果明显优于A组(P<0.05),手术开始后0、5、10和15min,A组在HR和MAP与B组相比明显增加(P<0.05),并且呼吸抑制程度也明显高于B组。结论氯胺酮-咪唑安定静脉复合加单次硬膜外腔阻滞麻醉具有以下优点:麻醉平稳,效果好,苏醒快,牵拉反射不明显,对心血管系统影响小,减少了静脉麻醉药物的用量,防止了药物蓄积或过量,降低了并发症的发生率等,因此,它是小儿浅表手术较为理想的麻醉方法。
Objective To compare the effects of two different anesthesia methods in pediatric lower abdomen superficial operations and to explore a better pediatric anesthesia method. Methods Forty infants underwent superficial abdominal surgery. The patients were randomly divided into two groups (A and B), 20 cases in each group. Group A was ketamine combined with midazolam combined anesthesia. Group B was ketamine combined with midazolam combined with single stiff Epidural block anesthesia; each group of patients under the control of anesthesia rating standards were observed and assessed. Results The effects of anesthesia in group B were significantly better than those in group A (P <0.05). At 0, 5, 10 and 15 minutes after the start of operation, the levels of HR and MAP in group A were significantly increased compared with group B (P <0.05) Also significantly higher than the B group. Conclusions Ketamine-midazolam combined with single epidural block anesthesia has the following advantages: stable anesthesia, good effect, fast recovery, no apparent traction and reflection, little effect on cardiovascular system and reduced dosage of intravenous anesthetics , To prevent the accumulation of drugs or excess, reducing the incidence of complications, therefore, it is an ideal method of pediatric shallow surface anesthesia.