全麻复合骶麻在婴幼儿腹腔镜手术中的应用  

Application of combined general anesthesia with sacral block in infant laparoscopic surgery

作　　者：朱广球[1] 尤匡掌[1] 

机构地区：[1]浙江省台州医院麻醉科,临海317000

出　　处：《江西医药》2006年第8期542-544,共3页Jiangxi Medical Journal

摘　　要：目的探讨全麻复合骶麻对于婴幼儿腹腔镜手术麻醉的优越性。方法选择年龄6个月～3岁腹腔镜手术40例,随机分为全麻复合骶麻组(Ⅰ组)和单纯全麻组(Ⅱ组),每组20例。骶麻药物为利多卡因与罗哌卡因复合液,容量为1ml/kg。Ⅰ组术中异丙酚以100～150μg/(kg·min),而Ⅱ组为150～200μg/(kg·min)持续静脉输注。比较两组术中血流动力学、拔管时间、苏醒期躁动和24h内恶心、呕吐的发生情况。结果气腹后10min、气腹后20minⅠ组的HR、MAP虽较气腹前升高,但明显低于Ⅱ组(P<0.05)。全麻复合骶麻组患儿拔管时间较单纯全麻组明显缩短,且苏醒期躁动及24h内恶心、呕吐的发生率亦较低。结论与单纯全麻相比,全麻复合骶麻用于婴幼儿腹腔镜手术既利于术中的循坏稳定、术后早期苏醒,又可减少术后躁动及恶心、呕吐的发生。Objective To investigate the advantage of combined general anesthesia with sacral block in infant laparoscopic surgery. Methods 40 infants underwent laparoscopic surgery, aged form 3 months to 3 years, were randomly assigned into two groups： Ⅰ and Ⅱ were group（n=20 per group）. Patients in group Ⅰ were recevied general anesthesia combined with sacral block. Patients in group Ⅱ recevied general anesthesia only. Propofol was infused at the rate of 100-150μg/（kg.min） intravenously in group Ⅰ ,and 150-200μg/ （kg·min） in the other. In group Ⅱ ,patients were recevied single caudal block （treated with lidocaine and ropivacaine）. Results The HR and MAP increased significantly at 10 and 20 minutes after establishing pneumoperitoneum in group Ⅰ but were lower compared with that in group Ⅱ （P〈0.05）. The time for extubation after surgery was shorter and the incidence of agitation was lower during recovery period significantly in group Ⅰ than that in group Ⅱ （P〈0.05）. There was a lower incidence of postoperative nausea and vomiting within 24 hours postoperatively in group Ⅰ compared with group Ⅱ. Conclusion Combined general anesthesia with sacral block is more suitable for infant laparoscopic surgery compared with general anesthesia, it may well stable the hemodynamics of intraoperation, shorten the awaken time, and with lower incidence of agitation ,nausea and vomiting postoperatively.

关 键 词：全身麻醉 骶管阻滞 婴幼儿 腹腔镜 

分 类 号：R614.2[医药卫生—麻醉学]