超声引导下行髂腹股沟及髂腹下神经阻滞麻醉在小儿腹腔镜腹股沟疝修补术中的应用

发布时间：2018-05-01 08:33

本文选题：超声 + 神经阻滞　；参考：《海峡药学》2016年06期

【摘要】：目的探讨经超声引导行髂腹股沟及髂腹下神经阻滞麻醉在小儿腹腔镜腹股沟疝修补术中的临床效果,并与传统体表定位下的同样术式进行比较。方法选择行腹腔镜下腹股沟疝修补术的患儿64例,年龄7~13岁,随机分为两组,两组患儿均常规行喉罩通气全身麻醉。观察组患儿经超声引导行髂腹股沟及髂腹下神经阻滞麻醉,对照组患儿经传统体表定位后行相同神经阻滞。比较两组患儿术中心率(HR)、血压(MAP)、脉搏氧饱和度(Sp O_2)的变化以及手术持续时间、麻醉药物用量(全麻药、局麻药)和并发症发生情况,观察术毕患儿清醒时间、术后镇痛持续时间以及术后首次应用镇痛药时间。结果两组患儿均顺利完成手术。观察组局麻药总用量更低,为9.3±3.5m L,而对照组为13.6±5.2m L(t=58.7,P0.05)。观察组术中舒芬太尼及异丙酚用量分别为7.5±3.8μg和140.7±14.4mg,而对照组分别为15.3±4.2μg和180.6±15.7mg;观察组的术后苏醒时间为7.2±1.5min,对照组为16.4±2.0min,两组比较有统计学意义(P0.05)。观察组患儿术后镇痛持续时间为225.0±36.0min,对照组为127.0±33.0min,两组比较有统计学意义(P0.05)。观察组不良反应显著低于对照组(P0.05)。结论在小儿腹腔镜疝修补术中经超声引导行髂腹股沟及髂腹下局部神经阻滞,可获得满意的麻醉效果,减少局部麻醉药用量和延长术后镇痛时间;术后并发症少,安全可行。
[Abstract]:Objective to investigate the clinical effect of supersonic guided ilioinguinal and inferior iliac nerve block anesthesia in laparoscopic inguinal hernia repair in children, and to compare it with the same operation under traditional body surface orientation. Methods 64 children, aged 713 years, who underwent laparoscopic inguinal hernioplasty, were randomly divided into two groups. The observation group received ilioinguinal and inferior iliac nerve block anesthesia guided by ultrasound, while the control group received the same nerve block after traditional body surface positioning. The changes of heart rate (HR), blood pressure mitogen (MAPP), pulse oxygen saturation (SPO _ 2), the duration of operation, the dosage of anesthetic (general anesthetic, local anesthetic) and complications were compared between the two groups, and the waking time after operation was observed. The duration of postoperative analgesia and the time of first application of analgesics after operation. Results the operation was successfully completed in both groups. The total dosage of local anesthetic in the observation group was lower (9.3 卤3.5m L), while that in the control group was 13.6 卤5.2m L ~ (-1) (P 0.05). The dosage of sufentanil and propofol in the observation group was 7.5 卤3.8 渭 g and 140.7 卤14.4 mg, respectively, compared with 15.3 卤4.2 渭 g and 180.6 卤15.7 mg in the control group, and the postoperative recovery time was 7.2 卤1.5 min in the observation group and 16.4 卤2.0 min in the control group. The duration of postoperative analgesia was 225.0 卤36.0 min in the observation group and 127.0 卤33.0 min in the control group. The adverse reactions in the observation group were significantly lower than those in the control group (P 0.05). Conclusion Ultrasound-guided local nerve block in ilioinguinal and inferior iliac groin during laparoscopic herniorrhaphy in children can obtain satisfactory anesthetic effect, reduce the dosage of local anesthetic and prolong the time of postoperative analgesia, and has fewer complications and is safe and feasible.
【作者单位】：福建省立医院麻醉科;福建医科大学省立临床医学院麻醉教研室;
【分类号】：R726.1

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