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目的探讨超声引导下髂腹股沟-髂腹下神经阻滞(IINB)复合七氟醚吸入麻醉在小儿斜疝手术中的临床效果。方法选取120例斜疝手术的患儿随机分为A组(n=60,氯胺酮复合丙泊酚静脉麻醉)和B组(n=60,七氟醚复合超声下IINB麻醉)。记录两组患儿手术切皮前1 min、切皮后1min的MAP、HR,麻醉诱导时间、术后苏醒时间、PACU留观时间;比较两组患儿术中发生镇痛不足和发生不良反应的例数;观察比较术后镇痛效果和家长满意度情况。结果 A组的诱导时间、苏醒时间、PACU留观时间明显高于B组(P<0.01);A组切皮前后1min的MAP和HR变化明显大于B组,组间差异有统计学意义(P<0.05);B组术中镇痛不足发生率低于A组(P<0.05);B组术后镇痛效果和家长满意度均高于A组(P<0.05);除A组有2例呼吸抑制外两组均未发现明显不良反应。结论七氟醚吸入麻醉复合超声引导下IINB用于小儿斜疝手术,麻醉平稳、苏醒迅速,术后镇痛效果好,不良反应少,家长满意度高。
Objective To investigate the clinical effect of ultrasound-guided anesthesia with inhalation of ilio-groin-ilio-abdominal nerve block (IINB) combined with sevoflurane in pediatric indirect hernia surgery. Methods Totally 120 children with indirect hernia surgery were randomly divided into group A (n = 60, ketamine propofol intravenous anesthesia) and group B (n = 60 anesthesia with sevoflurane combined with IINB). The MAP, HR, induction time of anesthesia, postoperative recovery time and PACU viewing time were recorded at 1 min before operation and 1 min after skin incision in both groups. Comparing the two groups, the occurrence of adverse analgesia and adverse reactions The number of cases; observed and compared postoperative analgesia and parental satisfaction. Results The induction time, recovery time and PACU observation time in group A were significantly higher than those in group B (P <0.01). The changes of MAP and HR in group A at 1 minute before and after incision were significantly higher than those in group B (P <0.05). The incidence of intraoperative analgesia in group B was lower than that in group A (P <0.05). Postoperative analgesia and parental satisfaction in group B were higher than those in group A (P <0.05) Cases of respiratory depression outside the two groups did not find significant adverse reactions. Conclusions IINB is used for pediatric indirect hernia operation under anesthesia combined with sevoflurane anesthesia. It has a stable anesthesia, rapid recovery, good postoperative analgesia, few adverse reactions and high satisfaction with parents.