黄立新

氯胺酮异丙酚复合利多卡因用于小儿手术麻醉临床效果观察

黄立新

目的 观察氯胺酮异丙酚复合利多卡因对小儿手术麻醉的疗效状况，并对临床效果进行探讨分析。方法 本文选择2010年4月～2015年4月医治的100例患儿进行前瞻性研究，利用随机分组的方式分为观察组与对照组，每组各50例患者，对照组给予单一的氯胺酮麻醉，观察组给予氯胺酮+异丙酚+利多卡因麻醉，对比两组患者的呼吸频率、收缩压、血氧饱和度、心率、清醒时间以及不良反应发生情况。结果 对照组和观察组患者麻醉前后的呼吸频率、收缩压、血氧饱和度以及心率均不存在明显差异（P＞0.05），均未出现明显的应激反应。观察组患者的清醒时间为（10.51±3.27）min，明显短于对照组的（17.75±6.46）min（P＜0.05）。观察组患者的不良反应发生率为10%，明显短于对照组的28%（P ＜0.05）。结论 氯胺酮、异丙酚复合利多卡因应用于患儿手术过程中进行麻醉，其麻醉的效果比较理想，而且产生的不良反应很少。

氯胺酮；异丙酚；利多卡因；小儿手术麻醉

【Abstract】

Objective To observe the effect of ketamine and propofol combined lidocaine anesthesia for pediatric surgery， and the clinical effect was analyzed and discussed. Methods 100 cases of pediatric patients were selected to a prospective study in April 2010 to April 2015， were randomly divided into observation group and control group， each had 50 cases. The control group was given a single ketamine anesthesia， the observation group was given ketamine+propofol+lidocaine anesthesia， two groups of patients with systolic blood pressure， respiratory rate， oxygen saturation， heart rate， waking time and the incidence of adverse reactions were compared. Results Control group and observation group of patients before and after anesthesia breathing rate， systolic blood pressure， oxygen saturation and heart rate， there was no significant difference （P＞0.05）， and there were no obvious stress reaction. In the observation group， the waking time was （10.51 ± 3.27）min， which was significantly shorter than that in the control group （17.75 ± 6.46） min （P＜0.05）. The incidence of adverse reactions in the observation group was 10%， which was significantly shorter than that in the control group of 28% （P＜0.05）. Conclusion Ketamine Combined with propofol and lidocaine in pediatric patients during surgery anesthesia， the anesthetic effect is ideal， and the resulting adverse reactions rarely.

【Key words】Ketamine，Propofol，Lidocaine，Pediatric surgery anesthesia

小儿耐受性较差，因此在外科手术时，需要进行全身麻醉［1］。正确并科学选择麻醉的药物，能有效提升患儿的手术麻醉效果，让患儿可以在短时间苏醒［2］。氯胺酮就是一种深度性的镇痛药物，对患儿的循环系统、呼吸系统影响都比较小，其临床镇痛的效果很好，广泛应用于患儿的麻醉，至今未出现可取代氯胺酮的麻醉药物。但当药量增大、手术时间延长，就会出现许多不良反应［3］。随着麻醉学迅速发展，其临床中主要应用复合麻醉。……