全麻联合骶管阻滞用于小儿腹股沟斜疝修补术的临床观察

Comparison of General Anesthesia and Combined General Anesthesia–Caudal Block in the Inguinal Hernia Repair in Children

目的探讨骶管阻滞对全麻下行腹股沟斜疝修补术的影响。方法ASAⅠ级2~5岁择期拟行腹股沟斜疝修补术的患儿100例,随机分为两组:对照组(n=50)应用静吸复合全麻;实验组(n=50)应用静吸复合全麻联合骶管阻滞。骶管阻滞用药为1%利多卡因1 mL/kg。术中连续监测心电图、血压、心率、呼吸、脉搏氧饱和度、呼气末二氧化碳浓度并相应调节吸入七氟醚的浓度。记录术中维持满意的麻醉效果所需要的MAC值、术后苏醒时间及苏醒时的MAC值,术后躁动等不良反应。结果实验组术中达到满意的麻醉效果所需要的MAC值显著低于对照组(P<0.01);术后拔除喉罩时间实验组短于对照组(P<0.01);苏醒时的MAC值实验组显著小于对照组(P<0.01);术后躁动的发生率实验组显著低于对照组(P<0.01)。结论全麻和全麻联合骶管阻滞均可安全有效用于小儿腹股沟斜疝修补术,联合骶管阻滞可以减少术中吸入全麻药的用量,术后苏醒迅速并且减少术后躁动的发生。

Objective To study the effect of caudalblock in children underwent inguinal hernia repairunder general anesthesia.Methods ASA classⅠ2-5 years old children 100 cases undergoing elective inguinal hernia repair were randomly divided into two groups:control group(n=50)use general anesthesia;the experimental group(n=50)use general anesthesia combined caudal block with 1%lidocaine 1 mL/kg.Intraoperative continuous monitoring changes in blood pressure,heart rate and breathing,intraoperative MAC value needed to achieve satisfactory anesthetic effect,post operation extubation time,MAC values when they wake up and postoperative adverse reactions.Results Compare to control group during operation the MAC value need to achieve satisfactory anesthetic effect was significantly lower(P<0.01);extubation time was shorter(P<0.01);wake-up MAC value is also lower(P<0.01);the incidence of postoperative agitation is alsosignificantly lower(P<0.01).Conclusion In children under went inguinal hernia repair the caudal block combined general anesthesia can reduce the dosage of intraoperative inhalation anesthetics,wake up quick and reduce the occurrence of postoperative agitation.