喉罩全麻联合腹横神经阻滞用于小儿腹腔镜疝气手术的麻醉效果与安全性分析  

Anesthesia Effect and Safety Analysis of Laryngeal Mask General Anesthesia Combined with Transverse Abdominal Nerve Block in Pediatric Laparoscopic Hernia Surgery

作　　者：何依红 杨庆耿 刘煌 周玉静 HE Yihong;YANG Qinggeng;LIU Huang;ZHOU Yujing(Department of Anesthesiology,Huizhou First Maternity and Child Health Hospital,Huizhou,Guangdong Province,516001 China)

机构地区：[1]惠州市第一妇幼保健院麻醉科,广东惠州516001

出　　处：《中外医疗》2021年第21期21-24,共4页China & Foreign Medical Treatment

基　　金：惠州市科技计划项目(20190402)。

摘　　要：目的分析喉罩(LMA)全麻联合腹横神经阻滞用于小儿腹腔镜疝气手术的麻醉效果与安全性。方法于2018年11月—2019年11月在该院就诊的疝气患儿中随机选取50例,以麻醉方法不同均衡分为两组,各25例,腹腔镜疝气手术时,对照组选择全麻诱导气管插管后静吸复合麻醉,观察组选择联合LMA全麻、腹橫神经阻滞,分析组间麻醉的效果。结果麻醉后,组间疗效对比,观察组(96.0%)较对照组(68.0%)高,差异有统计学意义(χ^(2)=4.878,P<0.05);观察组插管时、开始手术5 min、拔LMA时平均动脉压(MAP)分别为(34.34±8.43)、(34.23±6.38)、(34.37±8.74)mmHg,心率(HR)分别为(128.74±12.63)、(129.43±14.96)、(128.85±9.79)次/min,均较对照组低,而血氧饱和度(SPO2)分别为(97.13±1.36)%、(97.02±1.30)%、(98.66±1.31)%,均较对照组高,差异有统计学意义(P<0.05)。术后1 h、2 h、3 h镇痛评分(CHIPPS)、苏醒时间对比,观察组(0.52±0.25)分、(0.67±0.26)分、(0.94±0.49)分、(8.4±3.9)min均优于对照组;术后并发症发生率对比,观察组(4.0%)较对照组(32.0%)低,差异有统计学意义(t=3.344、3.142、3.161、3.194,χ^(2)=4.878,P<0.05)。结论小儿接受腹腔镜疝气手术治疗时,选择联合LMA全麻、腹橫神经阻滞麻醉,可显著改善呼吸的状况,缩短苏醒的时间,存在较好的镇痛效果,较高的安全性。Objective To analyze the anesthesia effect and safety of laryngeal mask(LMA)general anesthesia combined with transverse abdominal nerve block for pediatric laparoscopic hernia surgery.Methods Randomly selected 50 pediatric hernia patients who were in the hospital from November 2018 to November 2019.They were divided into two groups with different anesthesia methods,25 cases in each group.During laparoscopic hernia surgery,the control group chose general anesthesia after induction of tracheal intubation,combined intravenous inhalation and combined anesthesia,the observation group chose to combine LMA general anesthesia and transverse abdominal nerve block to analyze the effects of anesthesia between the groups.Results After anesthesia,the efficacy of the observation group(96.0%)was higher than that of the control group(68.0%),and the difference was statistically significant(χ^(2)=4.878,P<0.05).The mean arterial pressure(MAP)of the observation group was(34.34±8.43)mmHg,(34.23±6.38)mmHg,and(34.37±8.74)mmHg during intubation,5 min after operation,and LMA extraction,respectively.The heart rate(HR)were(128.74±12.63)times/min,(129.43±14.96)times/min and(128.85±9.79)times/min,respectively,which were lower than those of the control group.The blood oxygen saturation(SPO2)was(97.13±1.36)%,(97.02±1.30)%and(98.66±1.31)%,respectively,which were higher than the control group.The differences were statistically significant(P<0.05).The comparison of analgesia score(CHIPPS)and recovery time at 1 h,2 h and 3 h after operation showed that the observation group was better than the control group(0.52±0.25)points,(0.67±0.26)points,(0.94±0.49)points and(8.4±3.9)min was better than the control group.The incidence of postoperative complications in the observation group(4.0%)was lower than that in the control group(32.0%),with statistically significant difference(t=3.344,3.142,3.161,3.194,χ^(2)=4.878,P<0.05).Conclusion When children undergoing laparoscopic hernia surgery,the choice of combined LMA general anesthesia and trans

关 键 词：腹横神经阻滞 喉罩全麻 腹腔镜 疝气手术 麻醉效果 安全性 

分 类 号：R5[医药卫生—内科学]