不同麻醉方法对腹腔镜手术患儿插管和拔管前后心率及并发症的影响

Effect of different anesthesia methods on heart rate and complication before and after intubation and extubation in pediatric laparoscopic surgery

目的:探讨不同麻醉方法对腹腔镜手术患儿插管、拔管前后心率以及麻醉并发症的影响。方法:选取85例接受腹腔镜手术治疗的患儿为研究对象,根据麻醉方法的不同将患儿分成喉罩组和骶管阻滞复合喉罩组,比较两组患儿插管、拔管前后的心率以及并发症发生率。结果:喉罩组患儿各时间点的心率波动较大,而骶管阻滞复合喉罩组则较为平稳,在T1、T2、T3三个时间点,喉罩组患儿的心率均高于骶管阻滞复合喉罩组(t=7.051、12.073、13.317,P值均为0.000);喉罩组患儿术后并发症发生率为18.60%,高于骶管阻滞复合喉罩组患儿的4.76%(χ~2=3.922,P=0.048)。结论:骶管阻滞复合喉罩全身麻醉用于小儿腹腔镜手术中,能达到满意的麻醉效果,患儿术中心率稳定,麻醉并发症发生率低,值得在临床麻醉工作中推广。

Objective： To explore the effect of different anesthesia methods on heart rate and complication before and after intubation and extubation in pediatric laparoscopic surgery. Methods： 85 cases of children undergoing laparoscopic surgery from September 2016 to January 2016 were selected as the subjects and,according to the different methods of anesthesia,divided into group A（ laryngeal mask） and group B（ sacral block compound laryngeal mask）. The heart rate and the incidence of complications before and after intubation and extubation were compared. Results：The heart rate fluctuation at different time in group A was large while in group B was smooth; the heart rates at T1,T2 and T3 in group A were higher than those in group B（ t = 7. 0509,12. 073,13. 3165,P = 0. 0000）. The postoperative complications rate in group A was 18. 60%,which was higher than that in group B（ 4. 76 %）（ χ~2= 3. 922,P = 0. 048）. Conclusion： Sacral block compound laryngeal mask general anesthesia for pediatric laparoscopic surgery,with stable heart rate and low incidence of complications,can ensure the satisfactory effect and is worthy of popularization and application.