阿芬太尼在小儿尿道下裂手术骶管阻滞的麻醉效果  

The Anesthetic Effect of Alfentanil on Sacral Block in Infantile Hypospadias Surgery

作　　者：王萍 罗春芳[1] 欧阳卫东[1] 章征兵[1] 李明[1] 胡强 Wang Ping;Luo Chunfang;Ouyang Weidong;Zhang Zhengbing;Li Ming;Hu Qiang(Jiangxi Provincial Children's Hospital,Nanchang Jiangxi 330013,China)

机构地区：[1]江西省儿童医院,江西南昌330013

出　　处：《医疗装备》2023年第18期12-15,共4页Medical Equipment

基　　金：江西省卫生健康委科技计划(202211241)。

摘　　要：目的探讨阿芬太尼用于小儿尿道下裂手术骶管阻滞的麻醉效果。方法选取2021年11月至2023年2月医院收治的60例行尿道下裂手术患儿,以随机数字表法分成对照组和试验组,各30例。对照组麻醉采用1%利多卡因+0.25%罗哌卡因,试验组麻醉采用1%利多卡因+0.25%罗哌卡因+阿芬太尼20μg/kg,静脉麻醉后在超声引导下行单次骶管阻滞,丙泊酚静脉泵入维持。观察两组手术开始后0.5、1.0、2.0 h患儿心率(HR)、平均动脉压(MAP)和BIS值变化,并比较两组术中丙泊酚用量。结果两组手术与麻醉时间、术后不良反应发生率比较,差异无统计学意义(P>0.05);手术开始后0.5、1.0、2.0 h,对照组HR高于试验组,差异有统计学意义(P<0.05);手术开始后0.5、1.0 h,对照组MAP高于试验组,差异有统计学意义(P<0.05);手术开始后2.0 h,对照组MAP高于试验组,差异无统计学意义(P>0.05);手术开始后0.5、1.0、2.0 h,试验组BIS值均低于对照组,且术中丙泊酚用量少于对照组,差异有统计学意义(P<0.05)。结论阿芬太尼配伍利多卡因、罗哌卡因骶管阻滞用于小儿尿道下裂手术,可提供良好的术中镇静效果。Objective The anesthetic effect of afentanil on sacral block in infantile hypospadias surgery was investigated.Methods With the selection of sixty pediatric patients undergoing hypospadias surgery in hospitals from November 2021 to February 2023,they were randomly divided into the control group and the experimental group,with 30 patients in each group.The control group was anesthetized with 1%lidocaine+0.25%ropivacaine,while the experimental group was anesthetized with 1%lidocaine+0.25%ropivacaine+20μg/kg of alfentanil,and a single sacral block was performed under ultrasound guidance after intravenous anaesthesia,and propofol was maintained by intravenous pumping.The changes in heart rate(HR),mean arterial pressure(MAP),and BIS values were observed 0.5,1.0,and 2.0 hours after the start of surgery in two groups of children,and the intraoperative propofol dosage was compared between the two groups.Results There were no statistically significant differences in the anesthesia time and incidence of postoperative adverse reactions between the two groups of surgeries(P>0.05);At 0.5,1.0,and 2.0 hours after surgery,the HR of the control group was higher than that of the experimental group,with a statistically significant difference(P<0.05);At 0.5 and 1.0 hours after surgery,the MAP in the control group was higher than that in the experimental group,with a statistically significant difference(P<0.05);At 2.0 hours after surgery,the MAP in the control group was higher than that in the experimental group,and the difference was not statistically significant(P>0.05);At 0.5,1.0,and 2.0 hours after surgery,the BIS values of the experimental group were lower than those of the control group,and the intraoperative dosage of propofol was lower than that of the control group,with statistically significant differences(P<0.05).Conclusion Alfentanil combined with lidocaine and ropivacaine for sacral block in infantile hypospadias surgery can provide good intraoperative sedation effect.

关 键 词：阿芬太尼 罗哌卡因 利多卡因 骶管阻滞 

分 类 号：R695[医药卫生—泌尿科学]