全身麻醉复合喉罩联合髂腹下及髂腹股沟神经阻滞对腹股沟区手术患儿围术期的影响  

Effect of general anesthesia combined with laryngeal mask and iliohypogastric/ilioinguinal nerve block on perioperative children undergoing inguinal surgery

作　　者：罗文辉[1] 蓝雨雁[1] 

机构地区：[1]广西医科大学第一附属医院麻醉科,南宁市530021

出　　处：《广西医学》2016年第2期183-186,共4页Guangxi Medical Journal

基　　金：广西自然科学基金(2011GXNSFA018222);广西医疗卫生适宜技术研究与开发课题(S201414-06)

摘　　要：目的评价全身麻醉复合喉罩联合髂腹下与髂腹股沟神经阻滞对行腹股沟区手术患儿围术期的影响。方法择期行腹股沟区手术患儿60例,分为全身麻醉复合喉罩组(A组)、全身麻醉复合喉罩联合髂腹下及髂腹股沟神经阻滞组(B组)和静脉麻醉联合髂腹下及髂腹股沟神经阻滞组(C组),每组20例。观察3组手术时间、苏醒所需时间、恢复室(PACU)停留时间和丙泊酚总用量;入室时(T_1)、麻醉诱导或神经阻滞结束时(T_2)、切皮时(T_3)、牵拉疝囊时(T_4)、手术结束时(T_5)、苏醒时(T_6)患儿的HR和平均动脉压(MAP);苏醒时(T_6)、术后2 h(T_7)、4 h(T_8)、6 h(T_9)、12 h(T_(10))和24 h(T_(11))患儿的FLACC疼痛行为评分;苏醒期躁动、术后不良反应、术后应用镇静镇痛药的情况。结果 A组、B组的苏醒所需时间短于C组(P<0.05),A组与B组比较无差异(P>0.05);A组丙泊酚总用量多于B组、C组(P<0.05);3组的HR及MAP比较,差异均有统计学意义(P<0.05),其中在T_3、T_4时点,B组HR及MAP均低于A组及C组;3组PACU停留时间比较,差异均无统计学意义(P>0.05)。3组患儿不同时间FLACC评分差异有统计学意义(P<0.05),B组、C组评分低于A组。B组苏醒期躁动及术后恶心呕吐发生率、使用镇静镇痛药比例最低(P<0.05)。结论全身麻醉复合喉罩联合髂腹下及髂腹股沟神经阻滞运用于小儿腹股沟区手术,可以提供良好的术中及术后镇痛,有效缩短术后苏醒时间,减少全麻药物用量、苏醒期躁动及术后不良反应发生。Objective To evaluate the effect of general anesthesia combined with laryngeal mask and iliohypogastric/ilioinguinal nerve block on perioperative children undergoing inguinal surgery. Methods Sixty children undergoing selective inguinal surgery were divided into general anesthesia group （Group A）, general anesthesia combined with laryngeal mask and iliohypogastric/ilioinguinal nerve block group （Group B）, and intravenous anesthesia combined with laryngeal mask and iliohypogastric/ilioinguinal nerve block group （Group C） ,with 20 cases in each group. The operation time,time for recovery, stay in postanesthesia care unit （PACU） and consumption of propofol were observed in the three groups. When entrance （ T1 ）, anesthesia induction/nerve block finished （ T2 ）, skin incision （ T3 ）, pulling hernial sac （ T4 ）, the surgery finished（T5 ） and recovery （T6 ）, the heart rates （HR） and mean arterial pressures （MAP） of all children were observed. The score of The Face, Legs, Activity, Cry, Consolability Behavioral Tool （FLACC） was assessed in all children at the following time points, T6 ,2 （T7） ,4 （T8 ）, 6 （T9 ）, 12 （T10） and 24 hours （T11 ） after surgery. The restlessness during recovery, postoperative complications and the postoperative use of sedative and analgesic drugs were also observed. Results The time for recovery in Group A or Group B was shorter than that in Group C （P 〈 0.05 ）, and no significant difference was found between Group A and Group B （P 〉 0.05）. The consumption of propofol in Group A was more than that in Group B or Group C （ P 〈 0.05 ）. There were significant differences in HR and MAP among the three groups （ P 〈 0.05 ）, and HR and MAP in Group B were lower than those in Group A or Group C at T3 and T4. There was no significant difference in PACU stay among the three groups（P 〉0.05）. There was significant difference in FLACC score among the three groups at all time points（P 〈 0.05）, and the s

关 键 词：全身麻醉 髂腹下神经 髂腹股沟神经 神经阻滞 喉罩 儿童 围术期 

分 类 号：R614.2[医药卫生—麻醉学]