罗哌卡因骶管阻滞在小儿门诊手术中的观察

Observation on Efficacy of Caudal Block with Ropivacaine in Pediatric Outpatient Surgery

目的观察儿童门诊下肢手术中运用低浓度罗哌卡因骶管阻滞麻醉的效果、不良反应、离院时间和术后疼痛情况。方法择期门诊手术患儿30例,随机分为两组,1组为0.2%罗比卡因组,2组为丙泊酚-氯胺酮全静脉麻醉组。观察麻醉效果、局麻药毒性反应及术后常见并发症、术后镇痛效果、离院时间。结果两组病人在术中镇痛效果全部达到满意,不良反应发生率均低,但两组病人离院时间、术后疼痛情况及术后恶心呕吐比较差异有统计学意义。结论罗哌卡因单次骶管阻滞具有操作简单、能满足手术需要、对呼吸与循环影响小、麻醉管理较容易、并发症少、离院时间短,有较好的术后镇痛作用等优点,是儿童门诊下肢手术较理想的麻醉方法。

Objective To observe the effect,adverse reactions,the time of discharging from hospital,and postoperative pain of caudal anesthesia with low concentration of ropivacaine in pediatric outpatients which had lower extremity surgery. Methods Thirty elective surgical outpatients were randomly divided into 0.2% ropivacaine group and propofol-ketamine total intravenous anesthesia group.Anesthetic efficacy,local anesthetic toxicity,postoperative complications,postoperative analgesia,and time away from the hospital were observed. Results Intraoperative analgesic effects of all patients in the two groups were satisfactory.The incidence rate of adverse events was lower.But there were statistically significant differences in the time of discharging from hospital,postoperative pain and postoperative nausea and vomiting between the two groups. Conclusions Ropivacaine single caudal block has the advantages of simplicity,meeting the surgical needs,small effects on respiratory and circulatory systems, easier anesthesia management,fewer complications,shorter time of discharging from hospital and better postoperative analgesia effects,etc.It is an ideal anesthesia for pediatric outpatient underwent lower extremity surgery.