硬膜外麻醉用于小儿腹腔镜手术的临床研究  

Clinical study of epidural anesthesia undergoing laparoscopic surgery of children

作　　者：王开俊[1] 吴建平[1] 罗健[1] 李太富[1] 连铁[1] 黄龙[1] 丁亚山[1] 鲁爱民[1] 

机构地区：[1]广东省深圳市罗湖医院麻醉科,广东深圳518001

出　　处：《海南医学》2006年第2期33-33,152,共2页Hainan Medical Journal

摘　　要：目的观察小儿腹腔镜下腹部手术应用硬膜外麻醉的效果和对呼吸循环的影响。方法选择4～10岁ASAⅠ～Ⅱ级腹腔镜下行阑尾切除、疝囊腹壁内环口高位结扎术患儿50例;基础麻醉后行连续硬膜外麻醉,常规紧闭面罩给氧、辅助呼吸;术中监测MPA、HR、SPO2、PETCO2。结果患儿术中安静、麻醉满意、肌松良好、术毕10～20min苏醒;气腹后MPA、HR、RR、PETCO2均稍上升(P>0.05),放气后5min上述参数恢复正常。SPO2为98%～100%。结论连续硬膜外麻醉用于手术时间较短的腹腔镜小儿下腹部手术效果确切,对呼吸循环的影响轻,术毕苏醒快。Objective To observe the efficacy of epldural anesthesia in children＇s lower abdominal surgery by laparoscope, and to study the influence of it on breath and circulation. Methods 50 cases（4-10 years old, ASA Ⅰ-Ⅱ ） accepted appendectomy or ligation of inner ring of the oblique hernia by laparoscopy were selected; Continuous epidural anesthesia were performed after basal anesthesia, and assistant respiration were performed with mask oxygen inhalation. MPA,HR,SPO2,PETCO2 were monitored continuously during operation. Results All the cases were peaceful in whole operation and the degrees of the muscle relaxation of abdominal wall were good. The effects of anesthetic were satisfactory. All the patients recovered in 10-20 minutes after operation. The parameters of MPA, HR, RR and PETCO2 increased slightly after the establishment of pneumoperitoneum（P〉 0.05） and turn back to normal at 5 minutes after peritoneal deflation. The SPO2 were in the range from 98%- 100%. Conclusions Continuous epidural anesthesia is a good method for some of children＇s lower abdominal surgery by laparescope that need less tim.e It has satisfactory efficacy, it＇s influence on breath and circulation is slight, and the recovery times after operation is short.

关 键 词：小儿 腹腔镜 硬膜外 麻醉 

分 类 号：R614.42[医药卫生—麻醉学]