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目的观察咪唑安定和氯胺酮联合用药对小儿短小手术术后苏醒时间、苏醒期不良反应的影响,并与单纯用氯胺酮作比较。方法选择2~6岁择期下腹部会阴手术的患儿60例,美国麻醉师协会分级(ASA)Ⅰ~Ⅱ级,随机分成两组:Ⅰ组:氯胺酮4~6 mg/kg,肌肉注射;Ⅱ组:咪唑安定0.1 mg/kg+氯胺酮2 mg/kg,肌肉注射,入睡后行骶管阻滞麻醉,观察其苏醒时间和苏醒期间的不良反应。结果术后苏醒时间Ⅰ组明显长于Ⅱ组(P<0.05);苏醒期恶心呕吐、精神症状、烦躁不安等不良反应的发生率Ⅰ组明显多于Ⅱ组(P<0.05)。结论小剂量咪唑安定和氯胺酮联合用药辅助小儿骶管阻滞麻醉用于短小手术术后苏醒快,苏醒期不良反应少。
Objective To observe the effect of combination of midazolam and ketamine on the recovery time and awakening reaction after short operation in children, and to compare with ketamine alone. Methods Sixty children aged 2-6 years undergoing selective lower abdominal perineal surgery were randomly divided into two groups according to the American Society of Anesthesiologists (ASA) Ⅰ ~ Ⅱ: group Ⅰ: ketamine 4 ~ 6 mg / kg, intramuscular injection Ⅱ Group: Midazolam 0.1 mg / kg + ketamine 2 mg / kg, intramuscular injection, fall asleep after sacral block anesthesia to observe the recovery time and adverse reactions during awakening. Results The recovery time in group Ⅰ was significantly longer than that in group Ⅱ (P <0.05). The incidence of nausea and vomiting, psychotic symptoms and restlessness in group Ⅰ was significantly higher than that in group Ⅱ (P <0.05). Conclusion Small dose of midazolam combined with ketamine adjuvant pediatric caudal block anesthesia for short recovery after surgery, fast recovery less adverse reactions.