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目的探讨单纯氯胺酮麻醉在小儿腹股沟斜疝腹腔镜手术中的有效性和安全性。方法40例ASAⅠ~Ⅱ级择期行腹股沟斜疝腹腔镜手术的小儿随机分为两组,每组20例。分别采用氯胺酮麻醉和全身麻醉。持续监护小儿HR、MAP、SpO2、PETCO2术前、术中、术后进行比较,并行组间比较,记录主要药物用量,评估麻醉效果,记录可能发生的并发症和不良反应。结果A组在气腹前后HR、MAP无明显变化,B组HR、MAP明显升高(P<0.05),两组病人PETCO2气腹后较气腹前升高,且B组升高较A组更明显(P<0.05),两组病人SpO2变化不明显。气腹30 m in后PETCO2达最高峰,B组病人PETCO2气腹结束后恢复至气腹前水平的时间略短于A组。无严重不良反应发生。结论单纯氯胺酮麻醉能为小儿腹股沟斜疝腹腔镜手术提供安全、有效的麻醉,且降低患者经济负担。
Objective To investigate the efficacy and safety of simple ketamine anesthesia in pediatric inguinal hernia laparoscopic surgery. Methods Forty children with ASA Ⅰ ~ Ⅱ elective laparoscopic inguinal hernia were randomly divided into two groups (n = 20 in each group). Ketamine anesthesia and general anesthesia were used. The HR, MAP, SpO2 and PETCO2 in children were continuously monitored before, during and after operation. The patients were compared with each other in parallel. The main drugs were recorded, the anesthetic effect was evaluated, and the possible complications and adverse reactions were recorded. Results There was no significant change of HR and MAP in group A before and after pneumoperitoneum. The HR and MAP in group B were significantly increased (P <0.05), and PETCO2 in group B was higher than that in group before pneumoperitoneum More obvious (P <0.05), two groups of patients SpO2 did not change significantly. Pneumoperitoneum PETCO2 30min after the peak, Group B patients PETCO2 after pneumoperitoneum pneumoperitoneum to return to the level of time slightly shorter than the A group. No serious adverse reactions occurred. Conclusions Simple ketamine anesthesia can provide safe and effective anesthesia for pediatric inguinal hernia laparoscopic surgery and reduce the economic burden of patients.