喉罩吸入七氟醚联合髂腹股沟-髂腹下神经阻滞在小儿腹股沟区手术的应用  

Application of sevoflurane anesthesia under laryngeal mask airway combined with ilioinguinal-iliohypogastric nerve block in pediatric inguinal surgery

作　　者：肖建芳[1,2] 钟进财[1,2] 吴善苏[1,2] 张耀海[1,2] 

机构地区：[1]三明市第二医院 [2]福建中医药大学第五临床医学院麻醉科,福建永安366000

出　　处：《海南医学》2014年第21期3160-3162,共3页Hainan Medical Journal

基　　金：福建省三明市科技局科研立项资助(编号:2012-S-4)

摘　　要：目的比较喉罩吸入七氟醚联合不同阻滞麻醉方法在小儿腹股沟区手术的应用效果。方法选择择期行腹股沟区手术患儿90例,年龄1~4岁,随机分为喉罩吸入七氟醚联合髂腹股沟-髂腹下神经阻滞组（Ⅰ组）、喉罩吸入七氟醚联合骶麻组（Ⅱ组）、喉罩吸入七氟醚复合芬太尼组（Ⅲ组）,每组30例。术中保留自主呼吸。观察比较麻醉诱导前（T0）、切皮后3 min（T1）、开始缝皮时（T2）和手术结束时（T3）的心率和血压变化,以及苏醒时间、术中体动和术后不良反应的发生率。结果Ⅲ组苏醒时间为（12.7±3.6）min,与其相比,Ⅰ组和Ⅱ组的苏醒时间明显缩短,分别为（5.2±2.3）min、（4.9±2.6）min,差异有统计学意义（P〈0.05）;Ⅲ组开始缝皮时和手术结束时的心率、血压较Ⅰ组和Ⅱ组明显升高,差异有统计学意义（P〈0.05）;Ⅲ组术中体动和术后不良反应的发生例数较Ⅰ组和Ⅱ组多,但差异无统计学意义（P〉0.05）。结论三种麻醉方法均能良好地运用于小儿腹股沟区手术,喉罩吸入七氟醚联合髂腹股沟-髂腹下神经阻滞因其操作简便,易于掌握,苏醒及时,不良反应较少,能较好地运用于小儿腹股沟区手术。Objective To compare effects of sevoflurane anesthesia under laryngeal mask airway combined with different nerve block methods in pediatric inguinal surgery. Methods Ninety children, aged 1-4 years old, scheduled for elective inguinal surgery, were randomly divided into three groups （n=30 each） using a random number table： group I （sevoflurane anesthesia under laryngeal mask airway combined with ilioinguinal-iliohypogastric nerve block group）; group II （sevoflurane anesthesia under laryngeal mask airway combined with caudal block group）, group III （sevoflurane anesthesia under laryngeal mask airway combined with fentanyl）. The heart rate and blood pressure were observed at four time points： before induction of anesthesia （To）, three minutes after incision （%）, the start of sewing leather （1＂2） and the end of surgery （%）. The recovery time, intraoperative body movement and adverse effects were recorded. Results The recovery time of group Ⅲ was （12.7±3.6） min, significantly shorter than those of group I and group Ⅱ, （5.2±2.3） min, （4.9±2.6） rain, P〈0.05. Compared with group I and group Ⅱ, the heart rate and blood pressure were significantly higher at T2, T3 in group Ⅲ （P〈0.05）. Compared with group I and group Ⅱ, the incidence of body movement and adverse effects were more in group Ⅲ, but there was no significant difference （P〉0.05）. Conclusion The three anesthetic methods can be applied well in pediatrc inguinal surgery. Sevoflurane anesthesia under laryngeal mask airway combined with ilioinguinal-iliohypogastrc nerve block is preferred, with easy operation, quick waking up, few adverse reactions.

关 键 词：喉罩 七氟醚 神经阻滞 小儿 

分 类 号：R726.1[医药卫生—儿科]