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1、臂丛神经阻滞复合氯胺酮静脉麻醉在小儿上肢手术中探析【摘要】目的观察利用周围神经刺激器辅助定位,罗比卡因臂丛神经阻滞复合氯胺酮静脉麻醉在小儿上肢手术中应用,对呼吸循环功能以及术后恢复情况的影响。方法30例行上肢手术患儿随机分为两组:臂丛神经阻滞复合氯胺酮静脉麻醉组(A组),氯胺酮基础麻醉后,应用神经刺激器辅助定位臂丛阻滞成功后注入0.25%罗比卡因0.5ml/kg;单纯氯胺酮静脉麻醉组(B组),术中氯胺酮1~2mg/(kg•h)间断静脉注射。结果术中A组循环、呼吸功能较B组稳定;肢体不良自主运动,喉痉挛等不良反应较B组少,A组氯胺酮用量明显少于B组;术后A组
2、苏醒较快且平稳,恢复期精神症状少,与B组比有显著差异。结论臂丛神经阻滞复合氯胺酮静脉麻醉应用于小儿上肢手术,可减少氯胺酮用量从而减少其不良反应,使患儿在麻醉手术期间呼吸循环更平稳,家长及医护人员满意度明显提高。【关键词】臂丛神经阻滞;氯胺酮;静脉麻醉;手术BrachialplexusblockcombinedwithketamineintravenousanesthesiainpediatricsurgeryofupperextremityXUEMinqiang.HanchengMiningBureauGeneral7HospitalShanxi,hancheng71
3、5400,China【Abstract】ObjectiveToobservetheuseofperipheralnervestimulatorassistedpositioning,ropivacainebrachialplexusblockcombinedwithketamineintravenousanesthesiainpediatricupperextremitysurgeryapplications,pairsofrespiratoryandcirculatoryfunctionsandpostoperativerecoverysituation.Metho
4、ds30routineupperextremitysurgerywererandomlydividedintotwogroups:brachialplexusblockcombinedwithketamineintravenousanesthesiagroup(Agroup),ketaminebasedanesthesia,applicationofnervestimulatorassistedpositioningbrachialplexusblockinjected0.25%afterthesuccessofRomaniathanCain0.5ml/kg;pure
5、ketamineintravenousanesthesiagroup(Bgroup),intraoperativeketamine1~2mg/(kg•h)intermittentintravenousinjection.ResultsAgroupofcyclesintheresultsofsurgery,respiratoryfunctioncomparedwithBgroupstability;bodynegativeselfmovement,laryngealspasmfeweradverse7reactionsthantheBgroup,Agroup
6、ofketaminedosagewaslessthanB;afterAgroupofawakefasterandstablerecoveryperiodoffewerpsychiatricsymptoms,comparedwiththeBgroupweresignificantlydifferent.Conclusionbrachialplexusblockcombinedwithketamineintravenousanesthesiaforpediatricupperextremitysurgery,canreducethedosageofketaminetore
7、ducetheiradversereactionstoanesthesiainchildrenwithmorestableduringtherespiratoryandcirculatory,parentsandstaffsatisfactionhasimprovedsignificantly.【Keywords】Brachialplexusblock;Ketamine;Intravenousanesthesia;Surgery小儿上肢手术传统上常采用氯胺酮复合咪唑安定静脉麻醉方法,臂丛神经阻滞用于小儿上肢手术,麻醉操作简单、安全有效,但由于小儿多不
