不同麻醉方法用于小儿先天性巨结肠改良Soave根治术的比较研究

THE CLINICAL STUDY OF ANESTHESIA FOR SOAVE RADICAL OPERATION OF HIRSCHSPRUNG'S DISEASE ON CHILDREN

目的:评价骶管阻滞复合浅全麻和单纯全麻用于小儿先天性巨结肠改良Soave根治术的效果。方法:40例择期行先天性巨结肠手术的小儿,随机分A、B两组,每组20例。A组在骶管阻滞后进行全麻诱导气管插管,B组行单纯全麻气管插管,记录麻醉后各时点的MAP、HR、SpO2、PETCO2变化情况;全麻药和肌松药的使用量、肌松效果、苏醒时间、苏醒期情况等。结果:与B组相比,A组血流动力学平稳,全麻药和肌松药使用量少,肌松满意,苏醒时间短,苏醒期不良反应少。结论:在小儿先天性巨结肠改良Soave根治术中使用骶管阻滞复合浅全麻较单纯全麻具有镇痛完善、肌松满意、血流动力学稳定、苏醒快、苏醒质量高的优点。

Objective： To explore the effects between sacral anesthesia combined and general anesthesia using with general anesthesia alone for Soave Radical Operation of Hirschsprung＇s Disease on children. Methods： Forty children for operative surgery were divided into two groups： Group A was given sacral anesthesia combined with general anesthesia while Group B general anesthesia, and the effectiveness of perioperative hemodyamic change and complications were compared between the two groups. Comparison was also made in the dosage of anesthetic and muscle relaxant, and the awaking conditions. Results： Group A showed a significant steady perioperative hemodyamic change, while lower the dosage of anesthetic and muscle relaxant,better muscle relaxation, shorter awaking time compared with Group B. The difference between the two group was significant（ P〈0.05）. Conclusion： For Soave Radical Operation of Hirschsprung＇s Disease on children, sacral anesthesia combined with general anesthesia is more effective than general anesthesia alone and has no significant side effects.