超声引导下骶管与髂筋膜间隙阻滞在小儿发育性髋脱位矫正术中的应用比较  

Comparison of ultrasound-guided sacral canal and iliac fascia space block in the correction of developmental dislocation of the hip in children

作　　者：蒋富国 JIANG Fuguo(Beijing Chaoyang Emergency Medical Center,Beijing,100020,China)

机构地区：[1]北京朝阳急诊抢救中心,北京100020

出　　处：《当代医学》2022年第5期62-65,共4页Contemporary Medicine

摘　　要：目的探讨超声引导下骶管与髂筋膜间隙阻滞在小儿发育性髋脱位(DDH)矫正术中的应用效果。方法回顾性分析2017年1月至2018年10月本院收治的60例实施DDH矫正术患儿的临床资料,根据麻醉方式的不同分为A组(n=35)与B组(n=25)。A组采用全麻诱导后行超声引导下骶管阻滞麻醉,B组采用全麻诱导后行超声引导下髂筋膜间隙阻滞麻醉,比较两组麻醉效果、疼痛程度以及并发症发生率。结果 A组运动阻滞恢复时间、感觉阻滞起效时间均短于B组,镇痛维持时间长于B组,差异有统计学意义(P<0.05)。术后12、24、48 h,A组改良面部表情评分(FLACC)均低于B组,差异有统计学意义(P<0.05)。术中及随访期,A组并发症发生率低于B组,差异有统计学意义(P<0.05)。结论小儿DDH矫正术中,于全麻诱导后行超声引导下骶管阻滞麻醉能获取较好的麻醉效果,减少术后疼痛感,降低并发症发生率,安全性较高。Objective To explore the application of ultrasound-guided sacral canal and iliac fascia space block in the correction of developmental dislocation of the hip(DDH) in children. Methods The clinical data of 60 children who underwent DDH correction in our hospital from January2017 to October 2018 were retrospectively analyzed. They were divided into group A(n=35) and group B(n=25) according to different anesthesia methods. Group A received ultrasound-guided sacral canal block anesthesia after induction of general anesthesia, and group B received ultrasoundguided iliac fascia space block anesthesia after induction of general anesthesia. The anesthetic effect, degree of pain and incidence of complications were compared between the two groups. Results The recovery time of motor block and the onset time of sensory block in group A were shorter than those in group B, and the maintenance time of analgesia was longer than that in group B, the difference was significant(P<0.05). 12, 24 and 48 h after operation, the improved facial expression score(FLACC) in group A was lower than that in group B, the difference was significant(P<0.05).During operation and follow-up, the incidence of complications in group A was lower than that in group B, the difference was significant(P<0.05).Conclusion In the correction of DDH in children, ultrasound-guided sacral block anesthesia after induction of general anesthesia can obtain better anesthetic effect, reduce postoperative pain, reduce the incidence of complications and has high safety.

关 键 词：超声引导 骶管阻滞麻醉 髂筋膜间隙阻滞麻醉 疼痛程度 并发症 

分 类 号：R726.1[医药卫生—儿科]