七氟醚复合骶管内麻醉在婴儿手术中的应用

The application of sevoflurane with caudal anesthesia in infant operation

目的通过对七氟醚复合骶管内麻醉在婴儿手术应用中的临床观察，探讨适合婴儿下腹部手术的麻醉方式。方法将30例择其手术的患儿随机分为Ⅰ、Ⅱ两组，均采用七氟醚吸入诱导。Ⅰ组术中以七氟醚维持麻醉，Ⅱ组患儿入睡后行单次骶管阻滞，术中给予七氟醚吸入。记录诱导后（T1），手术切皮时（T2）和手术结束时（T3）的SpO2、HR、Bp值和患儿的苏醒时间，并观察术后恶心、呕吐、尿潴留、谵妄躁动等不良反应的发生率。结果Ⅰ组患儿的HR在T2时较T1时有显著增加（P〈0．05），Ⅱ组的苏醒时间及术后谵妄的发生率显著低于Ⅰ组（P〈0．05），其余指标两组差异无统计学意义。结论七氟醚复合骶管内麻醉极大减少了七氟醚的吸入量，术中躁动和术后谵妄的发生率明显降低，从安全性和有效性上都不失为一种适合小儿下腹部手术的麻醉方式。

Objective To investigate the better anesthesia method for infant hypogastric zone operation by observing to the clinical use of sevoflurane with caudal anesthesia. Method Tirty scheduled infant was divided into group Ⅰ and group Ⅱ（n=15）.Sevoflurane induction was used in both groups. Sevoflurane was used to maintained in group Ⅰ： caudal anesthesia was given after sleep in group Ⅱ and sevoflurane was inhaled during the operate. SpO2, HR and Bp after induction（T1）,in cutting（T2）, at the end（T3） and the analepsia time were recorded, the ratio of postoperation nausea and vomiting, urine retention, delirium was observed. Results HR of group Ⅰ at T2 increased significantly than T1（P〈0. 05） and in group If, the analepsia time and the ratio of delirium was more lower than group Ⅰ （P〈0. 05）.There were no statistical significance in other difference in both groups. Conclusion Sevoflurane with caudal anesthesia decreased the dosage of sevoflurane greatly, cut down restlessness in operation and delirium after operation, It could be a suitable method for infant hypogastric zone operation anyway.