超声引导喉上神经阻滞在小儿扁桃体腺样体等离子切除术中的应用效果

The Application Effect of Ultrasound-guided Superior Laryngeal Nerve Block in Plasma Resection of Pediatric Tonsils and Adenoids

目的:探究超声引导喉上神经阻滞在小儿扁桃体腺样体等离子切除术中的应用效果。方法:选择2022年8月—2023年3月于柳州市妇幼保健院进行扁桃体腺样体手术患儿60例,应用随机数字表法将其分为对照组及观察组,各30例。对照组行常规气管插管全麻,观察组行超声引导喉上神经阻滞复合全麻。比较两组入手术室后(T_(0))、可视喉镜置入声门即刻(T_(1))、导管进入气管即刻(T_(2))、插管后3 min(T_(3))的血流动力学指标[心率(HR)、平均动脉压(MAP)],比较两组插管时间、拔管时间、麻醉恢复室(PACU)停留时间及呛咳分级,比较两组进入PACU后10、20、30 min的儿童麻醉苏醒期躁动量表(PAED)评分。结果:两组T_(1)、T_(2)、T_(3)时HR、MAP均较T_(0)时升高,但观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组拔管时间、PACU停留时间均短于对照组,差异均有统计学意义(P<0.05)。观察组呛咳分级优于对照组,差异有统计学意义(P<0.05)。结论:小儿扁桃体腺样体等离子切除术时进行超声引导喉上神经阻滞,对血流动力学影响较小,并缩短苏醒时间,降低苏醒期躁动发生率,安全性较高。

Objective:To explore the application effect of ultrasound-guided superior laryngeal nerve block in plasma resection of pediatric tonsils and adenoids.Method:Sixty children who underwent plasma resection of tonsils and adenoids at Liuzhou Maternity and Child Healthcare Hospital from August 2022 to March 2023 were selected.They were divided into control group and observation group with 30 cases in each group by random number table method.The control group received routine tracheal intubation general anesthesia,while the observation group received ultrasound-guided superior laryngeal nerve block combined with general anesthesia.The hemodynamic indicators[heart rate(HR),mean arterial pressure(MAP)]of the two groups were compared after entering the operating room(T_(0)),immediately after glottis insertion with visual laryngoscope(T_(1)),immediately after trachea insertion(T_(2)),and 3 min after intubation(T_(3)).The intubation time,extubation time,postanesthesia care unit(PACU)residence time and coughing grade of the two groups were compared.The scores of pediatric anesthesia emergence delirium scale(PAED)at 10,20,30 min after entering PACU were compared between two groups.Result:HR and MAP at T_(1),T_(2) and T_(3) of two groups were higher than those at T_(0),but those of the observation group were lower than those of the control group,with statistical significance(P<0.05).The extubation time and PACU residence time in observation group were shorter than those in control group,the differences were statistically significant(P<0.05).The coughing grade of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The use of superior laryngeal nerve block during plasma resection for pediatric tonsils and adenoids has a relatively small impact on hemodynamics,reduces the incidence of agitation during the recovery period,and is relatively safe.