小儿疝修补术前麻醉用药中氯胺酮复合右美托咪定的效果分析
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摘要
目的评价小儿疝修补术前麻醉氯胺酮复合右美托咪定的效果。方法选择该院2017年1月—2018年8月期间行疝修补术治疗的80例患儿,以随机数字表法分组(参照组、试验组),参照组患儿接受氯胺酮麻醉,试验组患儿接受氯胺酮复合右美托咪定麻醉,对比两组患儿不同时间点心率变化情况、入睡时间、拔管时间、苏醒时间、不良反应发生率以及不同时间镇静评分占比率、情绪评分占比率情况。结果试验组、参照组用药20 min心率水平(95.2±16.8)次/min vs(106.0±17.5)次/min经统计学计算(t=2.815 6,P=0.006 2);用药30 min心率水平(94.0±17.5)次/min vs(109.8±18.3)次/min,经统计学计算(t=3.946 4,P=0.000 2);入睡时间(15.5±5.5)min vs(21.6±6.0)min经统计学计算(t=4.739 8,P=0.000 0);拔管时间(12.2±4.5)min vs(14.3±4.0)min经统计学计算(t=2.205 9,P=0.03032);苏醒时间(69.5±15.6)min vs (45.8±12.6)min经统计学计算(t=7.474 8,P=0.000 0);不良反应经(5.0%vs22.5%)统计学计算(χ~2=5.164 7,P=0.023 0)。结论氯胺酮复合右美托咪定利于疝修补术患儿与父母安静分离,术前麻醉用药效果理想,具有小儿手术应用价值。
Objective To evaluate the effect of ketamine combined with dexmedetomidine in pediatric hernia repair.Methods A total of 80 cases of children undergoing hernioplasty in our hospital from January 2017 to August 2018 were randomly divided into two groups: control group and experimental group. The control group received ketamine anesthesia, while the experimental group received ketamine combined with dexmedetomidine anesthesia. The changes of heart rate, sleeping time, extubation time, awakening time and adverse effects were compared between the two groups at different time points. The incidence of reaction, the proportion of sedation score and emotional score at different time were also discussed. Results The heart rate level of the experimental group and the reference group was(95.2±16.8)times/min and(106.0±17.5) times/min(t=2.815 6, P=0.006 2). After 30 min of medication, the heart rate level was(94.0±17.5) times/min(109.8±18.3) times/min(t=3.946 4, P=0.000 2). The sleeping time was(15.5±5.5)min and(21.6±6.0)min(t=4.739 8, P=0.000 0). The extubation time was(12.2±4.5)min and(14.3±4.0)min(t=2.205 9, P=0.030 32).The awaking time was(69.5±15.6)min and(45.8±12.6)min,(t=7.474 8, P=0.000 0). The adverse reactions were 5.0%and 22.5%(χ~2=5.164 7, P=0.023 0). Conclusion Ketamine combined with dexmedetomidine is conducive to the quiet separation of children with hernia repair and their parents. The effect of preoperative anesthesia is ideal, and it has the value of pediatric surgery.
Objective To evaluate the effect of ketamine combined with dexmedetomidine in pediatric hernia repair.Methods A total of 80 cases of children undergoing hernioplasty in our hospital from January 2017 to August 2018 were randomly divided into two groups: control group and experimental group. The control group received ketamine anesthesia, while the experimental group received ketamine combined with dexmedetomidine anesthesia. The changes of heart rate, sleeping time, extubation time, awakening time and adverse effects were compared between the two groups at different time points. The incidence of reaction, the proportion of sedation score and emotional score at different time were also discussed. Results The heart rate level of the experimental group and the reference group was(95.2±16.8)times/min and(106.0±17.5) times/min(t=2.815 6, P=0.006 2). After 30 min of medication, the heart rate level was(94.0±17.5) times/min(109.8±18.3) times/min(t=3.946 4, P=0.000 2). The sleeping time was(15.5±5.5)min and(21.6±6.0)min(t=4.739 8, P=0.000 0). The extubation time was(12.2±4.5)min and(14.3±4.0)min(t=2.205 9, P=0.030 32).The awaking time was(69.5±15.6)min and(45.8±12.6)min,(t=7.474 8, P=0.000 0). The adverse reactions were 5.0%and 22.5%(χ~2=5.164 7, P=0.023 0). Conclusion Ketamine combined with dexmedetomidine is conducive to the quiet separation of children with hernia repair and their parents. The effect of preoperative anesthesia is ideal, and it has the value of pediatric surgery.
引文
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[7]贾继娥,陈佳瑶,胡潇,等.氯胺酮复合或不复合右美托咪定作为白内障患儿术前用药的对比分析[J].复旦学报:医学版,2013,40(3):363-366.
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[2]李红新,徐宁,詹锦六,等.右美托咪定复合氯胺酮麻醉在颈淋巴结结核手术中的应用[J].广东医学,2017,38(6):944-946.
[3]侯素珍,韩宏剑.氯胺酮与咪达唑仑复合麻醉用于小儿疝修补术52例安全性评价[J].中国保健营养,2015,25(16):226.
[4]康琳,李泳.小剂量氯胺酮静脉麻醉复合髂腹股沟神经阻滞用于小儿疝修补术的效果观察[J].黑龙江医药,2014(6):1365-1367.
[5]蒋铭,杨现会,王军,等.右美托咪定和氯胺酮在小儿扁桃体切除术中的作用[J].天津医药,2017,45(9):984-987.
[6]王华.氯胺酮基础麻醉、氯胺酮+七氟烷麻醉在小儿外科手术中的应用探讨[J].今日健康,2016,15(7):131.
[7]贾继娥,陈佳瑶,胡潇,等.氯胺酮复合或不复合右美托咪定作为白内障患儿术前用药的对比分析[J].复旦学报:医学版,2013,40(3):363-366.
[8]帅建忠,郭浪涛,杨平亮等.氯胺酮复合右美托咪定用于小儿疝修补术前麻醉用药的临床效果观察[J].西部医学,2014,26(6):728-730.