右美托咪啶滴鼻联合骶管阻滞在小儿腹股沟斜疝修补术中的应用  

Application of Dexmedetomidine Intranasal Combined With Sacral Block in the Repair of Indirect Inguinal Hernia in Children

作　　者：周少武[1] ZHOU Shaowu(Department of Anesthesiology, Xiaogan Central Hospital, Xiaogan Hubei 432000, Chin)

机构地区：[1]湖北省孝感市中心医院麻醉科,湖北孝感432000

出　　处：《中国继续医学教育》2018年第2期72-75,共4页China Continuing Medical Education

摘　　要：目的探讨右美托咪啶滴鼻联合骶管阻滞在小儿腹股沟斜疝修补术中的麻醉效果。方法将40例腹股沟斜疝修补术的患儿随机分为两组,每组20例。研究组入室前30分钟给予右美托咪啶2μg/kg滴鼻,入室后行骶管阻滞,必要时行面罩吸入七氟醚。对照组经鼻滴入等容量的生理盐水,30分钟后将患儿抱入手术室,面罩吸入七氟醚后行骶管阻滞,术中必要时吸入七氟醚。记录两组患儿入室时的焦虑紧张情绪;手术开始切皮时T_0、提疝囊时T_1、手术结束缝合皮肤时T_2,各时间点HR、MAP及SPO_2的变化及七氟醚挥发罐的浓度百分值;麻醉苏醒时间;术后30 min、1 h、2 h的燥动情况。结果研究组小儿入室时的焦虑紧张情绪低于对照组(P<0.01);T_0、T_1、T_2各时间点HR、MAP的变化及七氟醚挥发罐的浓度百分值低于对照组(P<0.05);两组各时间点SPO_2的变化对比,差异无统计学意义(P>0.05),研究组小儿麻醉苏醒时间长于对照组(P<0.05);术后10 min、30min、1 h、2 h躁动情况低于对照组(P<0.05)。结论右美托咪啶滴鼻联合骶管阻滞在小儿腹股沟斜疝修补术中能产生良好的镇静,能减轻患儿入室时的焦虑情绪,使麻醉过程更平稳,能减少其他麻醉药的用量,减少术后躁动的发生。Objective To investigate the effect of dexmedetomidine intranasal combined with sacral block in the repair of indirect inguinal hernia in children.Methods 40 cases of inguinal hernia repair were divided into two groups randomly,with 20 cases in each group.Before 30minutes,the study group was given dexmedetomidine 2μg/kg nasal drops,burglary after sacral block,if necessary,mask inhalation of sevoflurane.The control group was dripped into saline with equal volume through the nose.After 30 minutes,the children were put into the operation room.The mask inhaled sevoflurane followed by sacral block and inhaled sevoflurane when necessary.The anxiety and tension of the two groups of children were recorded.The changes of HR,MAP and SPO2 at different time points and the concentration percentage of sevoflurane volatilization tank at T0 and T1,T2 at the beginning of operation and skin closure at the end of operation when skin incision was carried out at the beginning of operation.The time of anesthesia recovery and the dryness of 30 min,1 h and 2 h after operation.Results The anxiety and tension of the children in the study group were lower than that of the control group（P〈0.01）.The changes of HR and MAP at all time points of T0,T1 and T2 and the concentration of sevoflurane volatilization tank were lower than those of the control group（P〈0.05）.There was no significant difference in the change of SPO2 between the two groups at each time point（P〈0.05）.The anaesthesia time of the children in the study group was longer than that of the control group（P〈0.05）.The agitation of 10 min,30 min,1 h and 2 h after operation was lower than that of the control group（P〈0.05）.Conclusion Right metodetomidine intranasal combined with sacral block can produce good sedation in the repair of children＇s inguinal hernia.It can reduce the anxiety of the children in the room,make the anesthesia process more stable,reduce the amount of other anesthetics and reduce the occurrence of postoperative restlessness.

关 键 词：右美托咪啶 滴鼻 儿童 麻醉 骶麻 腹股沟斜疝修补术 

分 类 号：R445[医药卫生—影像医学与核医学]