罗哌卡因联合利多卡因骶管阻滞对小儿腹腔镜斜疝手术的麻醉效果及安全性  

Efficacy and safety of ropivacaine combined with lidocaine in caudal block for pediatric laparoscopic hernia surgery

作　　者：纪淑敏 沈燕平[1] 邹汶航 

机构地区：[1]宁波市妇女儿童医院麻醉科,浙江宁波315000

出　　处：《中国生化药物杂志》2016年第11期100-102,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的评价罗哌卡因联合利多卡因骶管阻滞对小儿腹腔镜斜疝手术的麻醉效果及安全性。方法选取2014年5月-2015年10月宁波市妇女儿童医院收治的70例择期小儿斜疝手术患儿,随机分为对照组35例与试验组35例,2组均给予术前常规检查,全麻插入喉罩后,采用7号头皮注射针头针刺进入骶管裂孔,对照组向内注入1%盐酸利多卡因注射液混合液1 m L/kg;试验组向内注入0.25%盐酸利多卡因注射液和0.25%盐酸罗哌卡因注射液混合液1 m L/kg;行小儿腹腔镜斜疝手术,术中持续泵入丙泊酚注射液4-6 m L/kg并容量控制通气给氧。比较2组手术结束时、手术结束后（0、0.5、1、2、4、8及24 h）视觉模拟疼痛评分（visual analogue scale,VAS）、视觉满意度评分（visual satisfaction scored,VSS）以及不良反应。结果试验组感觉及诱导阻滞持续时间短于对照组（P〈0.05）,患者术后2 h VAS评分试验组显著低于对照组（P〈0.05）。术后、术后0.5 h、术后1 h,试验组VSS评分显著低于对照组（P〈0.05）。试验组术后下肢麻木不适持续时间显著低于对照组（P〈0.05）。试验组术后患儿躁动发生率8.57%显著低于对照组的34.29%（P〈0.05）。试验组患者的不良反应发生率5.71%明显低于对照组的25.71%（P〈0.05）。结论罗哌卡因联合利多卡因骶管阻滞对小儿斜疝手术的麻醉效果显著,安全性高。Objective To evaluate the anesthetic effect and safety of ropivacaine combined with lidocaine caudal block in the treatment of pediatric laparoscopic hernia surgery. Methods A total of 70 cases with pediatric hernia surgery in Ningbo Women and Children＇s Hospital from May 2014 to October 2015 in this study were divided into control group and experimental group with 35 cases in each group. The patients in the both groups were given routine examination,preoperative anesthesia induction,adopted 7 scalp injection needles to prick into the hiatus sacralis,patients in control group were treated by 1% lidocaine hydrochloride injection mixed liquid 1 m L/kg; patients in the experimental group were treated by 0. 25% lidocaine hydrochloride injection and 0. 25% ropivacaine hydrochloric injection mixed liquid 1 m L/kg; pediatric hernia surgery,intraoperative continuous pumped into propofol injection 4-6 m L/kg and maintain the mask to the oxygen. The visual analog pain scored（ VAS）,visual satisfaction scored（ VSS） and adverse reactions were compared at the end of operation,after operation 0 h,0. 5 h,1 h,2 h,4 h,8 h and 24 h. Results The sensory and motor block effective time in the experimental group were later than the control group,the sensory and motor block duration time were shorter than the control group（ P〈0. 05）. VAS score of the experimental group was significant lower than control group after operation 2 h（ P〈0. 05）. After operation,postoperative 0. 5 h,postoperative 1 h,the VSS score of the experimental group was significant lower than control group（ P〈0. 05）. Lower limbs numbness discomfort duration time of the experimental group was significant lower than control group after operation（ P〈0. 05）. Postoperative agitation rate of the experimental group 8. 57% was significant lower than the control group 34. 29%（ P〈0. 05）. The incidence of adverse reactions of experimental group5. 71% was significant lower than the control group 25. 71%（ P〈0. 05）. Conclusion Ropivacaine

关 键 词：罗哌卡因 利多卡因 联合治疗 骶管阻滞 小儿斜疝手术 麻醉效果 安全性 

分 类 号：R614.2[医药卫生—麻醉学] R614.4[医药卫生—外科学]