Fuchs C, Schwabe M
Abteilung für Anästhesie und Intensivmedizin der Kreisgesundheitseinrichtungen Bad Salzungen.
Anaesthesiol Reanim. 1990;15(1):31-6.
In 70 children aged between 2 and 14 years the effect of rectal application of ketamine, diazepam and atropine was investigated. Administration was effected by suppositories in 38 children (group A) in four weight classes. Thirty-two children (group B) were premedicated by clysters depending on body weight. We found that the combination of drugs applied in group B showed significantly more effective premedication and enabled smooth induction of anaesthesia. Latency between application and induction was 20 minutes. Since a state of deep sleep can occur rapidly, a preoperative monitoring of the children is necessary. In contrast to group A, we found a smaller increase in heart rate in group B. But there were no differences in behaviour during and after operation between the groups. Despite the relatively small doses of ketamine, 12.8% of all children showed increased salivation. Therefore, this method of premedication should not be used without atropine. Since 11% of the patients vomited postoperatively, the use of dehydrobenzperidol instead of diazepam is discussed.
在70名年龄在2至14岁之间的儿童中，研究了直肠应用氯胺酮、地西泮和阿托品的效果。38名儿童（A组）根据四个体重级别通过栓剂给药。32名儿童（B组）根据体重通过灌肠进行术前用药。我们发现，B组应用的药物组合显示出明显更有效的术前用药效果，并能实现平稳的麻醉诱导。用药与诱导之间的潜伏期为20分钟。由于可能会迅速进入深度睡眠状态，因此对儿童进行术前监测是必要的。与A组相比，我们发现B组的心率升高幅度较小。但两组在手术期间和术后的行为没有差异。尽管氯胺酮剂量相对较小，但所有儿童中有12.8%出现流涎增加。因此，这种术前用药方法不应在不使用阿托品的情况下使用。由于11%的患者术后呕吐，因此讨论了使用地哌利多代替地西泮的问题。
