小儿唇腭裂手术麻醉中应用超声引导下喉上神经阻滞复合全麻的效果及安全性分析  

Effect and safety analysis of ultrasound-guided superior laryngeal nerve block combined with general anesthesia in children with cleft lip and palate operation

作　　者：管小红 GUAN Xiao-hong(Department of Anesthesiology,Dalian Women’s and Children’s Hospital(Group),Dalian 116012,China)

机构地区：[1]大连市妇女儿童医疗中心(集团)麻醉科,116012

出　　处：《中国实用医药》2021年第26期73-76,共4页China Practical Medicine

基　　金：大连市医学科学研究计划项目(项目编号:1811080)。

摘　　要：目的探讨超声引导下喉上神经阻滞复合全身麻醉(全麻)在小儿唇腭裂手术麻醉中的应用效果及安全性。方法60例小儿唇腭裂手术患儿,随机分为C组和U组,每组30例。C组应用常规气管插管全麻,U组应用超声引导下喉上神经阻滞复合全麻。比较两组患儿入室后(T_(0))、可视喉镜置入声门即刻(T_(1))、导管进入气管即刻(T_(2))、插管后3 min(T3)心率(HR)、平均动脉压(MAP)以及诱导时间、清醒时间、拔管时间、术后不良事件发生情况。结果T_(0)、T_(1)、T_(2)、T3时,两组患儿HR、MAP对比差异无统计学意义(P>0.05)。两组患儿均一次插管成功,插管时间对比差异无统计学意义(P>0.05);U组患儿清醒时间(7.39±2.25)min和拔管时间(9.44±2.72)min明显短于C组的(13.05±4.38)、(16.36±4.87)min,差异具有统计学意义(P<0.05)。U组患儿呛咳分级低于C组,差异具有统计学意义(P<0.05)。U组患儿术后躁动发生率为6.67%(2/30),低于C组的26.67%(8/30),差异具有统计学意义(P<0.05);两组患儿恶心呕吐、低氧血症发生率对比差异无统计学意义(P>0.05)。结论超声引导下喉上神经阻滞复合全麻应用在小儿唇腭裂手术麻醉中对血流动力学影响小,麻醉安全性高,可更快的清醒与拔管。Objective To discuss the practical effect and safety of ultrasound-guided superior laryngeal nerve block combined with general anesthesia in children with cleft lip and palate operation.Methods A total of 60 children with cleft lip and palate operation were randomly divided into group C and group U,with 30 cases in each group.Group C applied general anesthesia with conventional tracheal intubation,and group U applied ultrasound-guided supraglottic nerve block combined with general anesthesia.The heart rate(HR)and mean arterial pressure (MAP) after entering the operating room (T_(0)), immediately after visual laryngoscope placement in the voice box (T_(1)), immediately after catheter entry into the trachea (T_(2)), and 3 min after intubation (T_(3)), induction time, awake time, extubation time, and postoperative adverse events were compared between the two groups. Results At T_(0), T_(1), T_(2) and T_(3), there was no statistically significant difference in HR and MAP between the two groups (P>0.05). All children in both groups were successfully intubated at once, and the difference in intubation time was not statistically significant (P>0.05). The awake time (7.39±2.25) min and extubation time (9.44± 2.72) min of group U were obviously shorter than (13.05±4.38) and (16.36±4.87) min of group C, and the difference was statistically significant (P<0.05). The grade of coughing in group U was lower than that in group C, and the difference was statistically significant (P<0.05). The incidence of postoperative restlessness in group U was 6.67% (2/30), which was lower than 26.67% (8/30) in group C, and the difference was statistically significant (P<0.05). There was no statistically significant difference in incidence of nausea and vomiting, hypoxemia between the two groups (P>0.05). Conclusion Ultrasound-guided superior laryngeal nerve block combined with general anesthesia has little effect on hemodynamics of children with cleft lip and palate. It also has high anesthetic safety, and allows for faster awakening and

关 键 词：超声引导下 喉上神经阻滞 全身麻醉 小儿唇腭裂 

分 类 号：R726.1[医药卫生—儿科]