国际麻醉学与复苏杂志   2016, Issue (5): 4-4
    
喉罩全身麻醉复合骶管阻滞在非洲儿童手术中的应用
王磊1()
1.新泰市人民医院
Application of laryngeal mask airway anesthesia combined with sacral canal block in pediatric surgery
 全文:
摘要:

目的 观察喉罩全身麻醉复合骶管阻滞与单纯气管插管全身麻醉在非洲儿童手术中的应用,为儿童麻醉提供参考。 方法 4~6岁行下腹部及下肢部位择期手术的患儿60例,完全随机分为喉罩全身麻醉复合骶管阻滞麻醉组(A组)和单纯气管插管全身麻醉组(B组),每组30例。观察记录患儿麻醉诱导前(T0)、置入喉罩/气管导管前后(T1、T2)及术毕拔出喉罩/气管导管(T3)时的MAP、HR和SpO2,以及麻醉苏醒时间、术后VAS疼痛评分及副作用情况。 结果 两组患儿MAP、HR和SpO2在T0和T1时比较,差异无统计学意义(P>0.05);A组MAP和HR[(68±10) mmHg(1 mmHg=0.133 kPa)、(108±17) 次/min]在T2时明显低于B组[(91±8) mmHg、(139±18) 次/min](P<0.05);A组MAP和HR[(67±9) mmHg、(121±16) 次/min]在T3时也明显低于B组[(85±9) mmHg、(141±17) 次/min](P<0.05);A组术后VAS评分[(1.5±0.5) 分]明显低于B组[(6.5±1.5) 分](P<0.05),A组苏醒时间[(5.8±2.4) min]明显短于B组[(12.2±2.8) min](P<0.05),A组术后躁动(4例)明显低于B组(17例)(P<0.05),术后A组啼哭和呛咳的发生率也明显低于B组(P<0.05)。 结论 喉罩全身麻醉复合骶管阻滞麻醉在患儿诱导期和苏醒期有更加平稳的血流动力学,且术后疼痛明显降低、苏醒时间明显缩短、术后副作用发生率明显降低,是非洲儿童下腹部及下肢部位手术的一种较理想的麻醉方法。

关键词: 喉罩; 麻醉,全身; 骶管阻滞; 非洲儿童
Abstract:

Objective To observe differences between the application of laryngeal mask anesthesia combined with sacral canal block and single intratracheal anesthesia in African pediatric surgery and provide references for child anaesthesia. Methods Sixty 4-6 year-old children for lower abdominal or lower limb surgerywere randomly divided into two groups(n=30): laryngeal mask airway anaesthesia combined with sacral canal block group(group A) and single intratracheal anaesthesia group(group B). MAP, HR and SpO2 were recorded before induction of anaesthesia(T0), before and after intubation of laryngeal mask airway or tracheal tube (T1, T2) and after removal of laryngeal mask airway or tracheal tube(T3). The waking-up time, VAS pain scores and adverse reaction were recorded after surgery. Results There were no significant differences in MAP, HR and SpO2 between the two groups at T0 and T1 (P>0.05). The MAP and HR [(68±10) mmHg(1 mmHg=0.133 kPa), (108±17) bpm] values in group A were significantly lower than the MAP and HR [(91±8) mmHg, (139±18) bpm] values in group B at T2(P<0.05). The MAP and HR [(67±9) mmHg, (121±16) bpm] values in the group A were also significantly lower than the MAP and HR [(85±9) mmHg, (141±17) bpm] values in the group B at T3(P<0.05). The postoperative VAS values (1.5±0.5) in groups A were significantly lower than values (6.5±1.5) in the group B (P<0.05). The waking-up time [(5.8±2.4) min] in group A was significantly shorter than the time [(12.2±2.8) min] in group B (P<0.05). There are only 4 cases of postoperative agitation in group A which was significantly lower than that in group B (P<0.05). The frequencies of postoperative cry and cough in group A were significantly lower than that in group B. Conclusions The general anesthesia via laryngeal mask airway combined with sacral canal block in children during the induction and the waking-up time guaranteed more stable hemodynamics and significantly reduce postoperative pain, the waking-up time significantly shorten, significantly reduce the incidence of postoperative mania,so it is an more ideal anesthesia methed in lower abdominal or lower limb surgery.

Key words: Laryngeal mask airway; Anesthesia, general; Sacral canal block; African child