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目的 :观察比较安定和咪唑安定对儿童氯胺酮麻醉中的不同影响 ,寻求氯胺酮与苯二氮 艹卓 类药物的理想配伍。方法 :儿童静脉全麻 6 0例 ,ASA为Ⅰ～Ⅱ级 ,随机分为三组 ,每组 2 0例。分别静脉注射氯胺酮 2mg kg(Ⅰ组 )、安定5mg kg(Ⅱ组 )、咪唑安定 0 .2mg kg(Ⅲ组 )为诱导 ,以氯胺酮 2 0～ 5 0 μg kg·min泵注维持。记录各不同时段的SPO2 、HR、MAP及术后苏醒时间 ,精神症状及恶心呕吐发生率。结果 :①Ⅲ组的心血管系统的稳定性较Ⅰ组、Ⅱ组都强。Ⅱ组Ⅲ组无明显的呼吸抑制。②Ⅲ组苏醒时间较Ⅰ组、Ⅱ组明显缩短 ,精神症状及恶心、呕吐发生率较Ⅰ组、Ⅱ组也低。结论 :咪唑安定与氯胺酮复合麻醉用于儿童在保持心血管系统稳定 ,缩短苏醒时间及降低并发症等方面 ,更具优越性。
OBJECTIVE: To observe the different effects of diazepam and midazolam on ketamine anesthesia in children and to find the ideal combination of ketamine and benzodiazepine drugs. Methods: Sixty cases of general anesthesia in children and ASA grade Ⅰ ~ Ⅱ were randomly divided into three groups of 20 cases. Ketamine 2 mg kg (group Ⅰ), diazepam 5 mg kg (group Ⅱ), and midazolam 0.2 mg kg (group Ⅲ) were induced by intravenous injection and were maintained by infusion of ketamine 20 ~ 50 μg kg · min. The SPO2, HR, MAP, recovery time after surgery, psychiatric symptoms and nausea and vomiting were recorded at different time points. Results: ① The stability of the cardiovascular system of group Ⅲ was stronger than that of group Ⅰ and Ⅱ. Group Ⅱ Ⅲ no significant respiratory depression. ② The recovery time of group Ⅲ was significantly shorter than that of group Ⅰ and Ⅱ, and the incidence of psychiatric symptoms, nausea and vomiting was lower than that of group Ⅰ and Ⅱ. Conclusion: Combination of midazolam and ketamine anesthesia is superior to children in maintaining cardiovascular system stability, shortening the recovery time and reducing complications.