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  本文選題：超聲 + 神經(jīng)阻滯��； 參考：《海峽藥學(xué)》2016年06期

【摘要】：目的探討經(jīng)超聲引導(dǎo)行髂腹股溝及髂腹下神經(jīng)阻滯麻醉在小兒腹腔鏡腹股溝疝修補術(shù)中的臨床效果,并與傳統(tǒng)體表定位下的同樣術(shù)式進(jìn)行比較。方法選擇行腹腔鏡下腹股溝疝修補術(shù)的患兒64例,年齡7~13歲,隨機分為兩組,兩組患兒均常規(guī)行喉罩通氣全身麻醉。觀察組患兒經(jīng)超聲引導(dǎo)行髂腹股溝及髂腹下神經(jīng)阻滯麻醉,對照組患兒經(jīng)傳統(tǒng)體表定位后行相同神經(jīng)阻滯。比較兩組患兒術(shù)中心率(HR)、血壓(MAP)、脈搏氧飽和度(Sp O_2)的變化以及手術(shù)持續(xù)時間、麻醉藥物用量(全麻藥、局麻藥)和并發(fā)癥發(fā)生情況,觀察術(shù)畢患兒清醒時間、術(shù)后鎮(zhèn)痛持續(xù)時間以及術(shù)后首次應(yīng)用鎮(zhèn)痛藥時間。結(jié)果兩組患兒均順利完成手術(shù)。觀察組局麻藥總用量更低,為9.3±3.5m L,而對照組為13.6±5.2m L(t=58.7,P0.05)。觀察組術(shù)中舒芬太尼及異丙酚用量分別為7.5±3.8μg和140.7±14.4mg,而對照組分別為15.3±4.2μg和180.6±15.7mg;觀察組的術(shù)后蘇醒時間為7.2±1.5min,對照組為16.4±2.0min,兩組比較有統(tǒng)計學(xué)意義(P0.05)。觀察組患兒術(shù)后鎮(zhèn)痛持續(xù)時間為225.0±36.0min,對照組為127.0±33.0min,兩組比較有統(tǒng)計學(xué)意義(P0.05)。觀察組不良反應(yīng)顯著低于對照組(P0.05)。結(jié)論在小兒腹腔鏡疝修補術(shù)中經(jīng)超聲引導(dǎo)行髂腹股溝及髂腹下局部神經(jīng)阻滯,可獲得滿意的麻醉效果,減少局部麻醉藥用量和延長術(shù)后鎮(zhèn)痛時間;術(shù)后并發(fā)癥少,安全可行。
[Abstract]:Objective to investigate the clinical effect of supersonic guided ilioinguinal and inferior iliac nerve block anesthesia in laparoscopic inguinal hernia repair in children, and to compare it with the same operation under traditional body surface orientation. Methods 64 children, aged 713 years, who underwent laparoscopic inguinal hernioplasty, were randomly divided into two groups. The observation group received ilioinguinal and inferior iliac nerve block anesthesia guided by ultrasound, while the control group received the same nerve block after traditional body surface positioning. The changes of heart rate (HR), blood pressure mitogen (MAPP), pulse oxygen saturation (SPO _ 2), the duration of operation, the dosage of anesthetic (general anesthetic, local anesthetic) and complications were compared between the two groups, and the waking time after operation was observed. The duration of postoperative analgesia and the time of first application of analgesics after operation. Results the operation was successfully completed in both groups. The total dosage of local anesthetic in the observation group was lower (9.3 鹵3.5m L), while that in the control group was 13.6 鹵5.2m L ~ (-1) (P 0.05). The dosage of sufentanil and propofol in the observation group was 7.5 鹵3.8 渭 g and 140.7 鹵14.4 mg, respectively, compared with 15.3 鹵4.2 渭 g and 180.6 鹵15.7 mg in the control group, and the postoperative recovery time was 7.2 鹵1.5 min in the observation group and 16.4 鹵2.0 min in the control group. The duration of postoperative analgesia was 225.0 鹵36.0 min in the observation group and 127.0 鹵33.0 min in the control group. The adverse reactions in the observation group were significantly lower than those in the control group (P 0.05). Conclusion Ultrasound-guided local nerve block in ilioinguinal and inferior iliac groin during laparoscopic herniorrhaphy in children can obtain satisfactory anesthetic effect, reduce the dosage of local anesthetic and prolong the time of postoperative analgesia, and has fewer complications and is safe and feasible.
【作者單位】： 福建省立醫(yī)院麻醉科;福建醫(yī)科大學(xué)省立臨床醫(yī)學(xué)院麻醉教研室;
【分類號】：R726.1

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