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【摘要】目的：探討骶管阻滞复合基础麻醉在小儿腹腔镜疝气手术中的可行性、安全性。方法：选择1~5岁在腹腔镜下行疝囊高位结扎手术ASAⅠ~Ⅱ级患儿40例，随机分为两组。A组20例，基础麻醉后行骶管阻滞麻醉，术中持续低流量鼻导管吸氧；B组20例，常规全麻诱导气管插管后静吸复合麻醉；术中持续监测HR、MAP、SpO2、PETCO2、术毕苏醒时间、术中术后不良反应。结果：两组患儿气腹后HR、MAP、SpO2、PETCO2均高于气腹前(P<0.05)，组间比较差异无统计学意义(P>0.05)；A组苏醒时间明显优于B组，组间比较差异有统计学意义(P<0.05)；术中术后不良反应发生率A组稍高于B组，但比较差异无统计学意义(P>0.05)。结论：骶管阻滞复合基础麻醉用于小儿腹腔镜疝气手术效果确切，可以满足手术的需要。
【关键词】骶管阻滞；麻醉；小儿；腹腔镜；疝气
Application Research of Caudal Block Combined with Basic Anesthesia in Pediatric Laparoscopic Hernia Surgery/TAN Jian，ZHU Hong-niu.//Medical Innovation of China，2012，9(16):043-044
【Abstract】Objective:To evaluate the feasibility and safety of caudal block combined with basic anesthesia in pediatric laparoscopic hernia surgery.Methods:40 children(1~5 years old，ASA Ⅰ~Ⅱ)undergoing high ligation of hernia sac by laparoscopy，were randomized into two groups:Group A(n=20) and Group B(n=20).Patients in Group A underwent caudal block after basal anesthesia with persistent oxygen uptake.Patients in Group B took general endotracheal intubation combined with intravenous inhalational anesthesia.HR，MAP，SpO2，PETCO2，recovery time of consciousness and adverse effects were monitored during and after operation.Results:The HR，MAP，SpO2 and PETCO2 of both groups were increased after aeroperitoneum(P<0.05).There was no significant differences between the two groups(P>0.05).Recovery time of consciousness in Group A was obviously superior to Group B(P<0.05).The incidence rate of adverse reaction in Group A was a little higher than that in Group B，while no differences were found(P>0.05).Conclusion:The application of caudal block combined with basic anesthesia has firmly effects on pediatric laparoscopic hernia surgery and meets the operations needs.
【Key words】Caudal block;Anesthesia;Pediatric;Laparoscopy;Hernia
First-author’s address:The Third Affiliated Hospital of Guiyang Medical College，Duyun 558000，China
doi:10.3969/j.issn.1674-4985.2012.16.024
【关键词】骶管阻滞；麻醉；小儿；腹腔镜；疝气
Application Research of Caudal Block Combined with Basic Anesthesia in Pediatric Laparoscopic Hernia Surgery/TAN Jian，ZHU Hong-niu.//Medical Innovation of China，2012，9(16):043-044
【Abstract】Objective:To evaluate the feasibility and safety of caudal block combined with basic anesthesia in pediatric laparoscopic hernia surgery.Methods:40 children(1~5 years old，ASA Ⅰ~Ⅱ)undergoing high ligation of hernia sac by laparoscopy，were randomized into two groups:Group A(n=20) and Group B(n=20).Patients in Group A underwent caudal block after basal anesthesia with persistent oxygen uptake.Patients in Group B took general endotracheal intubation combined with intravenous inhalational anesthesia.HR，MAP，SpO2，PETCO2，recovery time of consciousness and adverse effects were monitored during and after operation.Results:The HR，MAP，SpO2 and PETCO2 of both groups were increased after aeroperitoneum(P<0.05).There was no significant differences between the two groups(P>0.05).Recovery time of consciousness in Group A was obviously superior to Group B(P<0.05).The incidence rate of adverse reaction in Group A was a little higher than that in Group B，while no differences were found(P>0.05).Conclusion:The application of caudal block combined with basic anesthesia has firmly effects on pediatric laparoscopic hernia surgery and meets the operations needs.
【Key words】Caudal block;Anesthesia;Pediatric;Laparoscopy;Hernia
First-author’s address:The Third Affiliated Hospital of Guiyang Medical College，Duyun 558000，China
doi:10.3969/j.issn.1674-4985.2012.16.024