超声引导下神经阻滞麻醉复合喉罩在儿童手术中的应用

发布时间：2018-03-25 16:13

本文选题：喉罩　切入点：超声引导　出处：《中国医药指南》2016年30期

【摘要】：目的对超声引导下神经阻滞麻醉复合喉罩在儿童手术中的应用价值进行分析。方法以我院2015年1月至2015年10月收治的192例下腹部及四肢手术患儿为研究对象,手术前行七氟烷面罩吸入直至患儿意识消失,常规监测生命体征,心率,血压,血氧饱和度,体温。开放外周静脉,上肢手术患儿在超声引导下经肌间沟入路行臂丛神经阻滞,注入8~15 m L罗哌卡因(0.2%~0.375%),下肢及下腹部手术患儿在超声引导下以1%利多卡因+0.25%罗哌卡因行骶管阻滞麻醉,剂量为1 m L/kg。加深吸入麻醉,静脉给予丙泊酚2.5 mg/kg后置入喉罩。手术中以丙泊酚持续泵入6~8 mg/kg维持麻醉。对比患儿切皮后,手术开始后20 min及手术结束后30 min的血流动力学变化情况。结果患儿切皮后,手术开始后20 min及手术结束后30 min的HR,平均动脉压MAP的变化不具备显著性差异(P0.05)。结论超声引导下神经阻滞麻醉复合喉罩对儿童手术能够有效保持血流动力学的稳定性,镇痛效果确实可靠,安全性高,值得临床推广应用。
[Abstract]:Objective to analyze the value of ultrasound guided nerve block anesthesia combined with laryngeal mask in children's operation. Methods 192 cases of lower abdomen and extremities operation in our hospital from January 2015 to October 2015 were studied. Before operation, sevoflurane mask inhalation until the children's consciousness disappeared, routine monitoring vital signs, heart rate, blood pressure, blood oxygen saturation, body temperature. The lower extremity and lower abdomen were treated with 1% lidocaine 0.25% ropivacaine under ultrasound guided sacral canal block anesthesia with a dose of 1 mL / kg. Propofol was injected intravenously into larynx after 2.5 mg/kg. Anesthesia was maintained with propofol for 6 mg/kg and 8 mg/kg. Hemodynamic changes were compared between 20 min after skin incision and 30 min after operation. There was no significant difference in mean arterial pressure (MAP) between 20 min after operation and 30 min after operation. Conclusion Ultrasound-guided nerve block anesthesia combined with laryngeal mask can effectively maintain hemodynamic stability in children. Analgesic effect is reliable, high safety, worthy of clinical application.
【作者单位】：青岛市中心医院麻醉科;青岛市妇女儿童医院麻醉科;
【分类号】：R726.1

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