髂腹下-髂腹股沟神经阻滞在6岁以上小儿疝气、鞘膜积液手术中的应用

Application on Hernia,Hydrocele Surgery Over 6 Years in Pediatric with Iliohypogastric-ilioinguinal Nerve Block Anesthesia

目的观察髂腹下-髂腹股沟神经阻滞复合静吸麻醉与静吸复合麻醉在6岁以上小儿疝气、鞘膜积液手术中的应用效果。方法选择6~12岁ASA I级患儿120例,其中疝气80例,鞘膜积液40例。随机分成两组,每组60例。Ⅰ组选择髂腹下-髂腹股沟神经阻滞,七氟醚、氯胺酮、丙泊酚复合麻醉。Ⅱ组选择七氟醚、氯胺酮、丙泊酚复合麻醉。结果Ⅰ组麻醉效果满意。两组患儿各时点生命体征的比较:Ⅱ组患儿在切皮时,向近端游离鞘突牵拉时,MAP、HR较Ⅰ组明显升高,差异有统计学意义。两组患儿不良反应的比较:Ⅱ组患儿不良反应发生的例数明显多于Ⅰ组,差异有统计学意义。结论髂腹下-髂腹股沟神经阻滞,七氟醚、氯胺酮、丙泊酚复合麻醉较七氟醚、氯胺酮、丙泊酚复合麻醉有优越性,髂腹下-髂腹股沟神经阻滞能明显提高麻醉效果。

Objective To observe the application effect on hernia,hydrocele surgery over 6 years in pediatric with iliohypogastric- ilioinguinal nerve block anesthesia. Method The 120 6- 12- year- old children with ASA grade I were chose,included hernia 80 cases and hydrocele 40 cases,and randomly divided into two groups with 60 cases in each group. GroupⅠwas given iliohypogastric- ilioinguinal nerve block,sevoflurane,ketamine,propofol combined anesthesia. GroupⅡ was given sevoflurane,ketamine,propofol combined anesthesia. Result The anesthetic effect was satisfactory for groupⅠ. The comparison of vital signs at different time points in two groups showed that the GroupⅡ were higher groupⅠin the MAP and HR. The GroupⅡ were higher groupⅠin adverse reaction occurrence rate. Conclusion Iliohypogastric- ilioinguinal nerve block,sevoflurane,ketamine,propofol combined anesthesia are superior to sevoflurane,ketamine,propofol anesthesia. Iliohypogastric- ilioinguinal nerve block can significantly enhance the the quality of anesthesia.