不同剂量苯磺顺阿曲库铵在小儿腹腔镜斜疝修补术中的临床观察

Clinical Observation of Different Doses of Cisatracurium Besylate in Laparoscopic Indirect Hernia Repair in Children

目的:探讨不同剂量苯磺顺阿曲库铵在小儿腹腔镜斜疝修补术中的应用效果。方法:选取2021年10月-2022年3月赣州市妇幼保健院收治的90例腹股沟斜疝患儿,按随机数字表法分为三组,各30例。所有患儿均接受气管插管全身麻醉+骶管麻醉,对照1组麻醉诱导时予以苯磺顺阿曲库铵0.1 mg/kg、对照2组予以0.05 mg/kg,观察组予以0.08 mg/kg。比较三组血流动力学变化、围术期情况、手术操作者满意度及不良反应发生情况。结果:三组入室(T_(0))、麻醉诱导后(T_(1))、插管后1 min(T_(2))、气腹时(T_(3))及气腹10 min(T_(4))时心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO_(2))相比,差异均无统计学意义(P>0.05);三组手术时间、麻醉诱导时间相比,差异均无统计学意义(P>0.05);对照2组苏醒时间、拔管时间均短于对照1组、观察组,差异均有统计学意义(P<0.05);观察组苏醒时间、拔管时间均短于对照1组,差异均有统计学意义(P<0.05);观察组、对照1组手术操作者满意度均高于对照组2组,差异均有统计学意义(P<0.05);观察组与对照1组手术操作者满意度相比,差异无统计学意义(P>0.05);三组不良反应发生率相比,差异无统计学意义(P>0.05)。结论:0.08 mg/kg苯磺顺阿曲库铵在小儿腹腔镜斜疝修补术中应用效果更佳,既可稳定术中血流动力学,还可缩短患儿术后拔管、苏醒时间,且手术操作者满意度较高,值得广泛应用。

Objective:To investigate the application effect of different doses of Cisatracurium Besylate in pediatric laparoscopic hernia surgery.Method:A total of 90 children with indirect inguinal hernia who were admitted to Ganzhou Maternal and Child Health Hospital from October 2021 to March 2022 were selected and divided into three groups according to the random number table method,with 30 cases in each group.All children were treated with tracheal intubation general anesthesia+sacral anesthesia.During anesthesia induction,Cisatracurium Besylate was administered at 0.1 mg/kg in control 1 group,0.05 mg/kg in control 2 group,and 0.08 mg/kg in observation group.The hemodynamic changes,perioperative conditions,satisfaction of operator and adverse reactions were compared among the three groups.Result:There were no significant differences in heart rate(HR),mean arterial pressure(MAP)and oxygen saturation of blood(SpO_(2))of the three groups after admission(T_(0)),after induction of anesthesia(T_(1)),1 min after intubation(T_(2)),during pneumoperitoneum(T_(3))and 10 min after pneumoperitoneum(T_(4))(P>0.05);there were no significant differences in the operation time and anesthesia induction time among the three groups(P>0.05).The recovery time and extubation time of control 2 group were shorter than those of control 1 group and observation groupthe differences were statistically significant,the differences were statistically significant(P<0.05);the recovery time and extubation time of the observation group were shorter than those of the control 1 group,the differences were statistically significant(P<0.05);the satisfaction of operators in observation group and control 1 group was higher than that in control 2 group,the differences were statistically significant(P<0.05);there was no significant difference in satisfaction of operators between the observation group and the control group(P>0.05);there were no significant differences in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:Cisatracurium Besylate with 0.08 mg/kg is more effective in laparoscopic indirect hernia repair in children,which can not only stabilize intraoperative hemodynamics,but also shorten the postoperative extubation and recovery time of children,and the satisfaction of operators is high,which is worthy of wide application.