骶管阻滞复合全麻用于小儿腹腔镜疝修补术临床观察  

Clinical Observation of Caudal Block Combined with General Anesthesia in Paediatric Laparoscopic Herniorrhaphy

作　　者：郭浪涛[1] 徐莉[1] 张成[1] 冉隆青[1] 徐晓燕[1] 

机构地区：[1]成都市儿童医院,四川成都610017

出　　处：《现代临床医学》2009年第3期182-183,共2页Journal of Modern Clinical Medicine

摘　　要：目的：研究骶管阻滞复合全麻用于小儿腹腔镜疝修补术的麻醉效果及对呼吸循环的影响并与单纯全麻比较。方法：ASAⅠ～Ⅱ级行小儿腹腔镜疝修补术的患儿50例。随机分为骶管阻滞复合全麻组（Ⅰ组）和全麻组（Ⅱ组），各25例。记录气腹前、气腹后15min、气腹解除后10min各时点平均动脉压（MAP）、心率（HR）、呼气末二氧化碳分压（PetCO2）。观察患儿苏醒拔管时间及患儿术后麻醉恢复期的不良反应。结果：与气腹前比较Ⅰ组气腹后15min MAP及HR变化差异无显著性（P〉0．05），Ⅱ组显著升高（P〈0．05）；两组患儿气腹后15minPetCO，均显著升高（P〈0．05）；停气腹后10min恢复至气腹前水平。Ⅰ组麻醉苏醒时间明显快于Ⅱ组；Ⅰ组术后躁动发生率显著低于Ⅱ组。术后恶心、呕吐发生率差异无显著性（P〉0．05）。结论：骶管阻滞复合全麻用于小儿腹腔镜疝修补术能有效抑制手术应激反应，保持循环稳定，麻醉效果满意，而且苏醒快，术后躁动发生少，是一种安全有效的麻醉方法。Objective： To observe the effectiveness of caudal block combined with general anesthesia in paediatric laparoscopic herniorrhaphy. Methods： Fifty ASA Ⅰ～Ⅱ grade pediatric patients undergoing laparoseopic herniorrhaphy were randomly divided into caudal block combined with general anesthesia group （ Group Ⅰ） and general anesthesia group （ Group Ⅱ）. The mean arterial pressure （MAP） , heart rate （HR） and end tidal carbon dioxide partial pressure （ PetCO2 ） in two groups before carbon dioxide pneumoperitoneum, 15 rain after pneumoperitoneum and 10 rain after rescission of peumoperitoneum were recorded too. The consciouseness recovery time and tracheal extubation time in two groups were recorded too. The adverse reactions during anesthesia recovery period in each group were observed. Results：The MAP arid HR in Group Ⅱ markedly rised 15 rain after carbon dioxide pneumoperitoneum, compared with that before pneumoperitoneum （P 〈 0.05 ）. However, no significant change was found in Group Ⅰ.The PetCO2 in two groups was obviously higher than that before pneumoperitoneum （P〈0.05）. The consciouseness recovery time and tracheal extubation time in Group Ⅰ were significantly shorter than those in Group Ⅱ（P 〈0.05）. Furthermore, the rate of restlessness during recovery in Group I was less that in Group Ⅱ（P 〈 0. 05）. Conclusion：Caudal block combined with general anesthesia is effective and safe for paediatric laparoscopic herniorrhaphy.

关 键 词：骶管阻滞 复合麻醉 小儿腹腔镜 疝修补术 

分 类 号：R614.2[医药卫生—麻醉学] R656.2[医药卫生—外科学]