【摘要】 目的:观察氯胺酮对儿童颌面外科短小手术七氟烷麻醉后苏醒期躁动(Emergency agitation,EA)的抑制作用。方法:择期口腔颌面部手术患儿35例美国麻醉医师协会(American society of auesthesiologists,ASA)Ⅰ级2～5岁,体重15～26 kg,随机分为2组,氯胺酮组(K组,n=20)和对照组(C组,n=15),2组患儿麻醉方法相同,8%七氟烷吸入诱导后罗库溴铵0.6 mg/kg静脉注射后经鼻气管插管,术中机械通气2%～3%七氟烷吸入维持,K组术毕前10 min静脉推注氯胺酮0.5 mg/kg,C组生理盐水,2组均于术毕停用七氟烷,待患儿苏醒后采用儿童麻醉苏醒期躁动评分(Pediatric anesthesia emergence delirium,PAED)量表评估并记录EA发生率,不良反应和监护室停留时间。结果:2组儿童一般资料无统计学意义,K组儿童术后EA发生率明显少于C组(P<0.01),但术后不良反应及监护室停留时间无差异。结论:氯胺酮能有效减少儿童经七氟烷麻醉口腔颌面部手术术后苏醒期EA发生率。更多还原

【Abstract】 Objective:To observe the inhibition effect of ketamine on emergency agitation(EA) of children suffering oral-maxillofacial surgery with sevoflurane anesthesia.Methods: 35 children with American society of auesthesiologists(ASA)Ⅰ,aged from 2 to 5 years old,and weighing 15~26 kg,were divided into 2 groups:ketamine group(group K,n=20) and control group(group C,n=15).Anesthesia method in the two groups was the same:nasal trachea intubated after 8% sevoflurane inhalation induction and rocuronium 0.6 mg/kg intravenous injection and 2%~ 3% sevoflurane to maintain with mechanical ventilation in two groups intraoperatively.Ketamine 0.5 mg/kg was injected in group K 10 min before the end of surgery intravenously,but normal saline in group C.Two groups ceased sevoflurane use after surgery.Then the occurrence of agitation rate and adverse reactions,and the time of postoperative stay in intensive care unit were evaluated and recorded with Pediatric Anesthesia emergence delirium(PAED) scale after the patients regained consciousness after anesthesia.Results: There was no difference in general information significantly.The incidence of emergence agitation in groups K was significantly less than that group C(P <0.01),while there was no difference in the incidence of adverse events or the time of intensive care unit stay.Conclusion: Ketamine is effective in reducing the incidence of emergence agitation of children who suffered oral-maxillofacial surgery with sevoflurane anesthesia.更多还原