连续骶管麻醉应用于小儿脐以下手术的临床观察

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1、韭海医药》2o10年3月第28卷第2期JHuaihaiMed．March2010．Vo1．28．No．2连续骶管麻醉应用于&JL脐以下手术的临床观察高田，朱琳琳【摘要】目的观察连续骶管麻醉在小儿脐以下手术中的应用效果。方法选择1个月到6岁拟行脐以下手术患儿6O倒，随机分为A、B两组，每组3O例，A组为氯胺酮基础麻醉加氯胺酮静脉麻醉，B组为氯胺酮基础麻醉加连续骶管麻醉。观察氯胺酮基础麻醉后(To)、手术切皮时(T。)及手术结束时(T2)三个时点患儿心率(HR)、收缩压(SBP)、舒张压(DBP)、脉搏血氧饱和度(SpO)

2、变化，手术期间体动、恶心呕吐发生率、氯胺酮总用量和术后患儿苏醒时间。结果A组HR、SBP、DBP在Tl、T2与T相比，均显著升高(P<0．05)，B组SBP和DBP三个时点无明显变化，但在T，、T2较A组低(P<0．05)，B组HR在T，、T2与T0及A组相应相应时点减慢(P<0．05)。2组SpO2比较差异无显著性(P>0．05)。B组氯胺酮总用量、恶心呕吐发生率及术后苏醒时间均较A组少(P<0．01)。B组术中平静，体动显著少于A组(P<0．01)。结论氯胺酮基础麻醉加连续骶管麻醉应用于小儿脐以下手术，麻醉效果确切

3、，惠儿平稳安静，副作用少，术毕苏醒迅速，可连续给药而不受时间限制。【关键词】骶管麻醉；外科手术；治疗结果；儿童【中图分类号】R614．4【文献标识码】A【文章编号】1008-7044(2010)02-0121-02Clinicalresearchofapplyingcontinuouscaudalanesthesiainpedo-operationbelowomphalos(OTian．ZHULin—lin．(BengbuFirstPeopleHo@ital，Anhui233000，China)【Abstract】ob

4、jectiveToevaluatetheclinicaleffectsofcontinuouscaudalanesthesiainpedo—operation．MethodsSixtychildren《ASAIor1I)aged1—72monthsunderwentoperationbelowanesthesia(ketamineim)andketamine1—2mkg．GroupBreceivedbasalanesthesia(ketamineim)andacontinuouscaudalbloekwithropiv

5、acaine0．125％～0．25％．Heartrate(HR)-systolicbloodpressure(SBP)，diastolicbloodpressure(DBP)，pulseoxygensaturation【SpO2)attiletimejustafterbas·alanesthesia(To)-immediatelyafterthebeginningoftheoperation(TI)andattheendoftheoperation(T2)wererecorded．Nauseaandvonfitting

6、frequency，ketaminedosageandrestlessnessfrequencywererecordedalso．ResultsIngroupA，con-paredwithTo。HR，SBPandDBPinTlandT2increasedsignificantly(P<0．05)．IngroupB，HR，SBPandDBPinthreetimepointshadnomarkedchange。butattimepointsTlandT2，theyhadsignificantdiferencecompare

7、dwiththoseingroupA(P<0．O5)．SpO2intwogroupsatthreetimepointshadnomarkedchange，nauseaandvomittingfrequency，ketaminedosageandrestlessnessfrequencyingronpBwerelessthanthatingroupAsignificantly(P<0．01)．ConclusionTheefectsofcontinu—OUScaudalblockafterbasalmmsthesiainp

8、edo—operationbelowomphalosinBP，HRandSpO2arestable。ketaminedosageissmall，childrenwakeupmoresoonerandnauseaandvomittingfrequencyislower．【Keywords】Caudalblock；Surgicalpr