超声辅助改良骶管阻滞麻醉用于婴儿腹股沟疝手术的临床分析

发布时间：2018-05-22 07:18

本文选题：麻醉 + 骶管　；参考：《第三军医大学学报》2015年13期

【摘要】：目的评价超声辅助改良骶管阻滞麻醉用于婴儿腹股沟疝手术的安全性和有效性。方法择期行腹股沟疝手术的患儿60例,年龄4~12个月,ASAⅠ或Ⅱ级,采用随机数字表法将患儿分为两组:传统方法组和改良方法组,每组30例。骶管阻滞采用0.15%罗哌卡因,推注速度0.5 m L/s,总量1 m L/kg,超声监测局麻药在硬膜外腔的扩散。记录患儿性别、年龄、体质量,麻醉诱导后(t1)、手术开始时(t2)、手术开始后10 min(t3)和手术结束时(t4)的心率、血压、呼吸、脉搏氧饱和度等生命体征。记录穿刺成功所需时间、穿刺次数、误入血管或蛛网膜下腔情况以及局麻药在硬膜外腔达到的最高节段。结果所有患儿生命体征平稳,骶管阻滞效果完善。传统方法组和改良方法组,局麻药达到腰1的比例分别为86.7%和83.3%。在传统方法组中,第1次穿刺成功率为83.3%,穿刺成功所需时间为(299.9±35.6)s,有3例误入血管和1例误入蛛网膜下腔。在改良方法组中,第1次穿刺失败率为96.7%,穿刺成功所需时间为(297.6±28.4)s,无误入血管或蛛网膜下腔的病例。结论采用超声辅助改良骶管阻滞法,穿刺成功率高,并发症少,阻滞效果完善。
[Abstract]:Objective to evaluate the safety and efficacy of ultrasound-assisted modified sacral block anesthesia in the operation of inguinal hernia in infants. Methods Sixty children with selective inguinal hernia operation, aged 4 to 12 months, were randomly divided into two groups: the traditional group and the modified group with 30 cases in each group. The sacral canal block was performed with 0.15% ropivacaine, the injection rate was 0.5 mL / s and the total dose was 1 mL / kg. The diffusion of local anesthetic in epidural cavity was monitored by ultrasound. The heart rate, blood pressure, respiration, pulse oxygen saturation and other vital signs were recorded, including sex, age, body mass, t _ 1 after anesthesia induction, T _ 2 at the beginning of operation, 10 min / t _ 3 at the beginning of operation, and t _ (4) at the end of operation. The time required for successful puncture, the number of punctures, the misentry into the vascular or subarachnoid space, and the highest level of local anesthetics in the epidural cavity were recorded. Results all the children's vital signs were stable and the effect of sacral canal block was perfect. In the traditional method group and the improved method group, the proportion of local anesthetic reaching waist 1 was 86.7% and 83.3%, respectively. In the traditional method group, the success rate of the first puncture was 83.3, and the time required for successful puncture was 299.9 卤35.6s. There were 3 cases into the blood vessel and 1 case into the subarachnoid space. In the modified method group, the failure rate of the first puncture was 96.70.The time required for successful puncture was 297.6 卤28.4 s, and there were no cases of vessel or subarachnoid cavity. Conclusion Ultrasound-assisted modified sacral canal block has high success rate, few complications and perfect effect.
【作者单位】：重庆医科大学附属儿童医院麻醉科儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室;
【基金】：国家临床重点专科建设项目(国卫办医函[2013]544)~~
【分类号】：R726.1

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