艾司氯氨酮复合丙泊酚在小儿肠套叠复位术中的应用研究

Application of esketamine combined with propofol in reduction of intussusception in children

摘要:

目的 探讨艾司氯氨酮复合丙泊酚在小儿肠套叠复位术中的应用效果。方法 选取2019年6月—2021年6月南通大学第二附属医院收治的86例拟行肠套叠复位术患儿为研究对象，按随机数字表法分为观察组和对照组，每组43例。两组患儿均行水压灌肠复位，对照组术中采用丙泊酚（2.5 mg/kg）进行静脉麻醉；观察组术中采用艾司氯氨酮（0.5～1.0 mg/kg）联合丙泊酚（2.0 mg/kg）静脉麻醉。比较两组患儿的复位情况、住院时间、Ramsay镇静评分、苏醒时间及与麻醉相关的不良反应；比较手术前后两组疼痛行为量表（FLACC）评分差值；随访6个月，比较两组复发情况。结果 两组患儿的复位成功率比较，差异无统计学意（P >0.05）；两组患儿住院时间比较，差异无统计学意义（P >0.05）；观察组苏醒时间短于对照组（P <0.05）；观察组Ramsay镇静评分低于对照组（P <0.05）；观察组手术前后FLACC评分差值高于对照组（P <0.05）；两组与麻醉相关的总不良反应发生率比较，差异无统计学意义（P >0.05）；两组复发率比较，差异无统计学意义（P >0.05）。结论 艾司氯氨酮复合丙泊酚应用于小儿肠套叠复位术中，具有良好的镇静镇痛效果和较高的复位成功率，可缩短苏醒时间，且安全可靠。

Abstract:

Objective To investigate the application effect of esketamine combined with propofol in the reduction of intussusception in children.Methods A total of 86 children with intussusception reduction surgery who were admitted to the hospital from June 2019 to September 2021 were selected as the research subjects, and they were divided into observation group (43 cases) and control group (43 cases) by random number method. Both groups of children underwent hydraulic enema reduction. In the operation control group, propofol (2.5 mg/kg) was used for intravenous anesthesia. In the observation group, esketamine (0.5 to 1.0 mg/kg) and propofol (2.0 mg/kg) were used for intravenous anesthesia. The reduction status, hospitalization time, Ramsay sedation score, recovery time, and anesthesia-related adverse reactions of the two groups of children were compared. The differences in scores of the Chinese version of the Children's Pain Behavior Scale (FLACC) between the two groups before and after surgery were compared. Follow-up for 6 months, the recurrence of the two groups were compared.Results There was no significant difference in the reduction success rate between the two groups of children (P > 0.05). There was no statistically significant difference in hospitalization time between the two groups (P > 0.05). The recovery time of the observation group were shorter than those of the control group (P < 0.05), and the Ramsay sedation score of the observation group was lower than that of the control group (P < 0.05). The difference of FLACC score before and after operation in the observation group was higher than that in the control group (P < 0.05). There was no significant difference in the incidence of total adverse reactions related to anesthesia between the two groups (P > 0.05). After 6 months of follow-up, there was no significant difference in the recurrence rate between the two groups (P > 0.05).Conclusion Esketamine combined with propofol is used in the reduction of pediatric intussusception. It has a good sedative and analgesic effect and reduction success rate, can shorten the recovery time, and is safe and reliable.