超声引导腹横肌平面阻滞联合Proseal喉罩通气麻醉在小儿腹腔镜疝囊高位结扎术中的应用  

The Application of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Proseal Laryngeal Mask Airway Anesthesia in Pediatric Laparoscopic High Ligation of Hernial Sac

作　　者：汪志勇[1] 方进龙[1] 涂远艳[1] WANG Zhiyong FANG Jinlong TU Yuanyang(Department of Anesthesiology, Dongguan Maternal and Child Health Care Hospital, Dongguan 523000, Chin)

机构地区：[1]东莞市妇幼保健院麻醉科,广东东莞523000

出　　处：《临床医学工程》2017年第8期1041-1042,共2页Clinical Medicine & Engineering

基　　金：东莞市医疗卫生一般项目(项目编号:2016105101067)

摘　　要：目的研究超声引导腹横肌平面(TAP)阻滞联合Proseal喉罩通气麻醉在小儿腹腔镜疝囊高位结扎术中的应用效果。方法选取2014年6月至2016年10月期间在我院行腹腔镜疝囊高位结扎术的106例患儿,随机分为两组各53例。研究组在术中行超声引导下TAP阻滞联合Proseal喉罩通气麻醉,对照组行单纯Proseal喉罩全麻。结果研究组在手术开始时和缝腹膜时的HR和MAP水平均显著低于对照组(P<0.05)。研究组患儿的苏醒时间显著少于对照组,苏醒期躁动发生率显著低于对照组(P<0.05)。两组的术后不良反应发生率无统计学差异(P>0.05)。结论小儿腹腔镜疝囊高位结扎术中应用超声引导TAP阻滞联合Proseal喉罩通气麻醉是一种理想的麻醉方式,患儿术中血流动力学平稳,苏醒快,躁动发生率少,术后不良反应发生率低。Objective To study the application effect of ultrasound-guided transversus abdominis plane （TPA） block combined with Proseal laryngeal mask airway （LMA-Proseal） anesthesia in pediatric laparoscopic high ligation of hernial sac. Methods 106 cases of children with laparoscopic high ligation of hernial sac in our hospital from June 2014 to October 2016 were selected and randomly divided into two groups equally. The study group received ultrasound-guided TPA block combined with LMA-Proseal anesthesia, while the control group received LMA-Proseal anesthesia only. Results At the beginning of surgery and at the stitching of peritoneum, the levels of HR and MAP of study group were significantly lower than those of control group （P 〈0.05）. The awakening time of study group was significantly shorter than that of control group, and the incidence of restlessness was significantly lower than that of control group （P〈0.05）. No statistical difference was found between two groups in the incidence of postoperative adverse reactions （P 〉0.05）. Conclusions Ultrasound-guided TPA block combined with LMA-Proseal anesthesia is an ideal anesthesia mode, which has stable intraoperative hemodynamics, fast recovery, and low incidences of restlessness and postoperative adverse reactions.

关 键 词：腹腔镜疝囊高位结扎术 腹横肌平面阻滞 Proseal喉罩通气麻醉 

分 类 号：R614[医药卫生—麻醉学]