单纯喉罩全身麻醉联合超声引导腹横肌平面阻滞在小儿疝囊高位结扎术麻醉中的效果

Anesthesia effect of simple laryngeal mask combined with ultrasound-guided transversus abdominis plane block in pediatric hernia sac ligation

目的探讨单纯喉罩全身麻醉联用超声引导腹横肌平面阻滞在小儿疝囊高位结扎术麻醉中的效果。方法选取2015年1月～2016年7月我院的120例腹股沟斜疝患儿，择期行疝囊高位结扎术。随机分为研究组和对照组，各60例。对照组采用单纯喉罩全身麻醉，研究组在对照组基础上联用超声引导腹横肌平面阻滞，对两组患儿不同时间点血压、心率的变化情况、手术时间、苏醒时间、瑞芬太尼用量、12h小儿疼痛量表（FLACC）评分及不良反应情况进行综合比较。结果插入喉罩后3min、手术切皮时、拔除喉罩时，研究组患儿的收缩压（SBP）、舒张压（DBP）、心率（HR）均较对照组降低（P〈O．05）；两组手术时间比较差异无统计学意义（P〉0．05）；研究组苏醒时间、瑞芬太尼用量、12hFLACC评分较对照组优（P〈0．05）；研究组出现相关不良反应发生率为5．0％，较对照组的18．3％低（P〈0．05）。结论单纯喉罩全麻联用超声引导腹横肌平面阻滞应用于小儿疝囊高位结扎术中麻醉效果确切，患儿血流动力学稳定，疼痛轻微，不良反应少。

Objective To investigate the anesthesia effect of simple laryngeal mask combined with ultrasound- guided transversus abdominis plane block in pediatric hernia sac ligation. Methods 120 cases of inguinal hernia children cured in our hospital from January 2015 to July 2016 were randomly divided into research group and control group with 60 cases in each group. Patients in control group were treated with simply laryngeal mask anesthesia. Patients in research group were treated with simple laryngeal mask combined with ultrasound-guided transversus abdominis plane block. Operation time, recovery time, remifentanil dosage, FLACC score, blood pressure, heart rate in different time and adverse reactions rate were compared. Results At time of 3 minutes after laryngeal mask inserted, skin incision, laryngeal mask inserted unplugged, the SBP, DBP and HR of research group were lower than those of control group （P 〈 O.05）.There was no significant difference in operation time between two groups（P 〉 0.05）. Recovery time, remifentanil dosage, FLACC score of research group were better than those of control group （P 〈 0.05）. Adverse reactions rate of research group was lower than that of control group（P 〈 0.05）. Conclusion Simple laryngeal mask combined with uhrasound-guided transversus abdominis plane block has exact effect for pediatric hernia sac ligation. Children has stable hemodynamics,mild pain and lower adverse reactions rate in this anesthesia method.