超声引导下会阴入路阴茎背神经阻滞用于尿道成形术的效果  

Feasibility analysis of ultrasound-guided penile dorsal nerve block in urethroplasty

作　　者：王苹 鲁海兵 贾英萍 Wang Ping;Lu Haibing;Jia Yingping(Department of Anesthesiology,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院(河南省儿童医院,郑州儿童医院)麻醉科,郑州450018

出　　处：《河南外科学杂志》2022年第6期12-14,共3页Henan Journal of Surgery

基　　金：河南省医学科技攻关计划(LHGJ20190956)。

摘　　要：目的 探讨超声引导下会阴入路阴茎背神经阻滞用于喉罩全麻尿道成形术的效果。方法 择期行喉罩全麻尿道成形术患儿60例,ASA分级I~Ⅱ级,年龄3~6岁,体质量10~25 kg。采用随机数字表法分为2组,各30例。A组复合超声引导下骶管阻滞,B组复合超声引导下会阴入路阴茎背神经阻滞。记录2组患儿的术中情况,统计2组患儿的术后临床指标。结果 2组患儿术前的阴茎体积、术后苏醒时间和PACU停留时间的差异均无统计学意义(P>0.05)。A组患儿神经阻滞15 min后的阴茎体积大于B组,手术时间和术中罗哌卡因用量多于B组,差异均有统计学意义(P<0.05)。2组患儿恶心呕吐、躁动、下肢运动阻滞并发症发生率差异均无统计学意义(P>0.05)。A组患儿术后首次使用镇痛泵自控时间长于B组,差异有统计学意义(P<0.05)。2组患儿的苏醒时间、苏醒期躁动评分(PAED)和疼痛评分(FLACC),24 h内镇痛泵按压次数,以及PACU停留时间的差异均无统计学意义(P>0.05)。结论 超声引导下会阴入路阴茎背神经阻滞用于喉罩全麻尿道成形术,可缩小阴茎体积,有利于减少手术时间、术中罗哌卡因用量,并可延长术后首次使用镇痛泵自控时间和缩短PACU停留时间。Objective To investigate the effect of ultrasound-guided perineal approach to penile dorsal nerve block in laryngeal mask general anesthesia urethroplasty. Methods Sixty children with hypospadias, ASA I~Ⅱ, aged 3~6 years, weighing 10~25 kg, were selected. Random number table method was used to divide the patients into 2 groups with 30 cases each. Caudal block under ultrasound guidance in group A and perineal nerve and dorsal penile nerve block under ultrasound guidance in group B. The intraoperative conditions of the two groups of children were recorded, and the postoperative clinical indicators of the two groups were statistically analyzed. Results There were no significant differences in preoperative penile volume, postoperative recovery time and PACU residence time between 2 groups(P>0.05). After 15 min of nerve block, the penile volume in group A was larger than that of group B, and the operative time and dosage of ropivacaine were larger than those of group B. The differences were statistically significant(P<0.05). There were no significant differences in the incidence of complications of nausea, vomiting, agitation and lower limb movement stagnation between 2 groups(P>0.05). The first postoperative analgesic pump control time of group A was longer than group B, and the difference was statistically significant(P<0.05). There were no significant differences in the recovery time, PAED and FLACC scores, the number of analgesia pump pressure within 24 h, and PACU residence time between the 2 groups(P>0.05). Conclusion Ultrasound-guided perineal approach to penile dorsal nerve block for laryngeal mask general anesthesia urethroplasty can reduce the size of the penis, reduce the operation time, the amount of ropivacaine, and it can prolong the first use of analgesic pump self-control time and shorten PACU residence time.

关 键 词：会阴入路阴茎背神经阻滞 超声引导 尿道下裂手术 

分 类 号：R614.2[医药卫生—麻醉学]