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目的:观察丙泊酚或丙泊酚复合氯胺酮辅助骶管麻醉用于小儿下腹部以下手术的临床效果。方法:60例2～8岁行下腹部以下部位择期手术患儿,按麻醉用药不同随机分为P组(丙泊酚组)和PK组(丙泊酚复合氯胺酮组),2组均辅助骶管麻醉,观察患儿麻醉前、麻醉后5 min、10 min心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_2)、呼吸频率(R)的变化以及术后清醒时间、术后恶心呕吐等不良反应发生情况。结果:(1)2组MAP、HR麻醉前后比较差异有统计学意义(P<0.05),组间差异无统计学意义(P>0.05);(2)2组R、SpO_2麻醉前后及组间比较差异无统计学意义(P>0.05);(3)术后清醒时间P组明显短于PK组(P<0.01),术后恶心呕吐等不良反应发生率P组明显低于PK组(P<0.05)。结论:丙泊酚辅助小儿骶管麻醉用于小儿下腹部以下手术麻醉效果满意,术后清醒迅速,不良反应少,围术期安全性高,其临床效果优于丙泊酚复合氯胺酮。
Objective: To observe the clinical effect of propofol or propofol combined with ketamine adjuvant caudal anesthesia for pediatric lower abdomen surgery. Methods: Sixty children aged 2 to 8 underwent elective surgery under the lower abdomen. The patients were randomly divided into P group (propofol group) and PK group (propofol combined ketamine group) according to different anesthetic drugs. The two groups were assisted by sacral The changes of heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO_2) and respiratory rate (R) before anesthesia and anesthesia were observed at 5 min and 10 min after anesthesia. Postoperative nausea and vomiting and other adverse reactions occurred. Results: (1) There was significant difference in MAP and HR between the two groups before and after anesthesia (P <0.05), there was no significant difference between the two groups (P> 0.05); (2) (P> 0.05). (3) The postoperative awake time was significantly shorter in P group than in PK group (P <0.01). The incidence of postoperative nausea and vomiting was significantly lower in P group than in P group <0.05). CONCLUSION: Propofol-assisted pediatric caudal anesthesia is satisfactory for anesthesia in children under the lower abdomen. The postoperative wakefulness is rapid, the adverse reactions are few and the perioperative safety is high. The clinical effect is superior to that of propofol combined ketamine.