Evaluation of effect of ketamine combined with different sedative and anesthetic drugs in children's short surgery

Abstract

OBJECTIVE To study anesthesia effect and safety of ketamine combined with dexmedetomidine in short surgery in children. Methods Selected 60 cases of American Society of Anesthesiologists (ASA) I ~ II grades, children with short surgery, aged 2 ~ 7 years, weighing 10 ~ 30kg, and divided into three groups according to random double-blind method, 20 cases in each. All patients received intramuscular injection of ketamine 4–5 mg • kg", atropine 0.01 mg • kg" and midazolam 0.05 mg • kg" before operation. After child enters operating room, he/she will be given oxygen inhalation by mask with oxygen flow rate of 1 ~ 2L/min, and establish a venous pathway. He/she will be given 10% glucose injection 100ml intravenous drip. A: ketamine 1.5 mg • kg "was given intravenously before skin incision, and same amount of normal saline was continuously pumped intravenously; B: ketamine 1.5 mg • kg was given intravenously before skin incision, and dexmedetomidine was pumped intravenously at a load of 0.5µg • kg for 15 min, and then operation was completed at a speed of 0.25 pg • kg • h '; C: Ketamine 1.5 mg/kg was given intravenously before skin incision, and dexmedetomidine was pumped intravenously at a load of 1µg • kg for 15 min, then operation was completed at a speed of 0.5 pg • kg • h '. During operation, 1.5 mg • kg ketamine was given intravenously and intermittently according to degree of anesthesia and surgical stimulation of children. During perioperative period, ECG, mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (\(Sp{O_2}\)) of children were continuously monitored, and dose of ketamine added during operation, postoperative waking time and sedation degree score (Ramsay sedation score), as well as preoperative and postoperative blood glucose values were recorded. Results There was no change in \(Sp{O_2}\) during perioperative period; The MAP and HR increased during perioperative period. Compared with increase of MAP and HR, A > B > C, but no difference between A and B, and a difference between A and C; Compared with dosage of additional phenone, dosage of A was much higher than B and C; The Ramsay sedation scores of children after operation showed that A < B < C; The recovery time of children in C was longer than A and B; Compared blood glucose changes before and after operation, A was higher than B and C. Conclusion Dextrmedetomidine pumped with 0.5µg · kg load and 0.25µg · kg maintenance can reduce occurrence of restlessness after ketamine operation without respiratory inhibition, and has no effect on recovery time after operation, and can inhibit stress of hand operation to a certain extent. It can be safely used for anesthesia of children's short operation.