RESUMO
Objective:To investigate the clinical effect of non-intubation anesthesia with ketamine combined with dexmedetomidine for elective surgery after burns in children.Methods:From January 2018 to December 2019, 50 children with burns who underwent elective surgery and were admitted to the Hanchuan People′s Hospital were enrolled and they were divided into the control group and the observation group by random number table, with 25 cases in each group. Both groups were given ketamine 1-2 mg/kg for induction of anesthesia, the control group was given propofol 4 mg/(kg·h) constant-rate pump injection, and the observation group was given dexmedetomidine 1 μg/(kg·h) pump injection for 10 min and then 0.5 μg/(kg·h) to maintain pump injection. The number of basic anesthesia, operation time and intraoperative fluid infusion between the two groups were compared. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO 2) at enter the operating room (T 1), 1 min before operation (T 2), 3 min after operation (T 3), end of the operation (T 4), recovery (T 5) points in the two groups were recorded and compared. The occurrence of adverse anesthesia reactions in the two groups and postoperative recovery were compared. Results:There was no statistically significant difference in the number of basic anesthesia, operation time, and intraoperative fluid infusion between the two groups ( P>0.05). The levels of MAP and HR did not change significantly at different time points in the control group ( P>0.05); the level of SpO 2 at T 2 and T 3 was lower than that at T 1 and was lower than that in the observation group at the same time point ( P<0.05); the levels of MAP and HR in the observation group at T 2, T 3, T 4, and T 5 were significantly lower than that at T 1, and were lower than that in the control group at the same time point ( P<0.05). The incidence of adverse reactions in the control group was higher than that in the observation group: 24.0%(6/25) vs. 4.0%(1/25), and the difference was statistically significant ( P<0.05); the scores of sedation and restlessness scale in the control group was higher than that in the observation group: (3.14 ± 0.76) scores vs. (1.22 ± 0.41) scores, the scores of the Ramsay score in the control group was lower than that in the observation group: (1.53 ± 0.36) s cores vs.(3.27 ± 30.41) scores, and the differences were statistically significant ( P<0.05). Conclusions:It is safe and effective to use ketamine combined with dexmedetomidine for non-intubation anesthesia during elective surgery after burns in children. The clinical anesthesia effect is significantly better than that of ketamine combined with propofol.