Application Of Ketamine And Dexmedetomidine Given In Short Anesthesia In Children

Objective:To investigate the anesthetic effect and safety of ketamine combined with dexmedetomidine in children with short non-intubation surgery.Methods:Selecting the 60 cases of non-intubation in pediatric surgery,dividing into three groups according to a random double-blind method.Each group have 20 cases.The patients are ASAⅠ^Ⅱ,aged from 2⁷,weighing 10³0kg.Intramuscular injecting ketamine（4⁵mg/kg）,atropine（0.01mg/kg）midazolam（0.05mg/kg）before the surgery.After a conventional oxygen mask into the operating room,the oxygen flow rate of 1²L/min,establishing venous access,intravenous injection of 10%glucose 100ml.Group A:Intravenous injecting ketamine（1.5mg/kg）in the precutaneous vein and the same amount of normal saline was given by intravenous injection;Group B:Intravenous injecting ketamine（1.5mg/kg）in the precutaneous vein and intravenous injection of dexmedetomidine at a dose of 0.5μg·kg^-1for 15min and intravenous injection at a rate of0.25μg·kg^-1·h^-1to the end of the operation;Group C:Intravenous injecting ketamine（1.5mg/kg）in the precutaneous vein and intravenous injection of dexmedetomidine at a dose of 1μg/kg for 15min and intravenous injection at a rate of0.5μg·kg^-1·h^-1totheendoftheoperation;Intravenousinjecting ketamine（1.5mg/kg）according to the degree of anesthesia and the degree of surgical stimulation..Continuous monitoring electrocardiogram（ECG）,mean arterial pressure（MAP）,heart rate（HR）and pulse oximetry（SpO₂）.And recording intraoperative additional ketamine dose,postoperative awake time and sedation score（using Ramsay sedation score）,and the preoperative and postoperative blood glucose values.Results:SpO₂ in the three groups of children did not change significantly during the anesthesia;MAP and HR were increased in the three groups,increased in A>B（P>0.05）,A>C（P<0.05）.The dose of ketamine in group A was much higher than that in B and C（P<0.05）.Ramsay sedation score,A<B<C（P<0.05）.Postoperative recovery time,C>A,B（P<0.05）.Blood glucose changes,A>B,C（P<0.05）.Conclusion:With 0.5μg·kg^-1load and 0.25μg·kg^-1·h^-1maintenance dose,dexmedetomidine can reduce the Irritability after using ketamine with stable hemodynamics.And dexmedetomidine don’t have respiratory inhibition,and no significant effect on postoperative recovery time,and it can inhibit surgical stress to a certain extent.It can be safely used on short pediatric anesthesia.