七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果分析

目的:观察七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果。方法:选取80例行腹股沟疝气手术患儿,按随机数字表法分为两组,对照组(39例)静脉注射氯胺酮,观察组(41例)先吸入8%七氟醚,然后进行骶管阻滞麻醉,通过观察并记录两组患儿生命体征、麻醉诱导时间、苏醒时间、手术麻醉时间、苏醒期躁动评分(Pediatric anesthesia emergence delirium,PAED)和麻醉诱导期合作量表(Induction Compliance Checklist,ICC)及麻醉期间不良反应情况,评价七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果。结果:两组切皮后T1、T2时心率(HR)、平均动脉压(MAP)水平均高于T0时的值(P0.05),两组切皮后T1、T2时组间HR、MAP水平相比,无统计学差异(P0.05)。两组切皮后T3时HR、MAP水平基本恢复到T0时的水平。两组切皮前后4个时间点的血氧饱和度(Sp O2)相比,无统计学差异(P0.05)。观察组患儿麻醉诱导时间,苏醒时间均明显短于对照组患儿(P0.05),两组术中麻醉持续时间相比,无统计学差异(P0.05),均能达到期望麻醉时间,观察组患儿PAED评分和ICC评分均低于对照组患儿(P0.05),不良反应组间比较无统计学差异(P0.05)。结论:七氟醚联合骶管阻滞麻醉对小儿疝气手术具有良好的麻醉效果,麻醉诱导快,苏醒快,小儿配合度高,术后躁动少,值得临床推广使用。

Anesthetic Effect of Sevoflurance Combined with Sacral Block Anesthesia in Treatment of Pediatric Hernia Surgery

ABSTRACT Objective: To discuss the anesthetic effect of sevoflurance combined with sacral block anesthesia in treatment of pediatric hernia surgery. Methods: 80 children with inguinal hernia surgery were selected, they were divided into two groups randomly. The control group (39 cases) was given ketamine by intravenous injection. The observation group(41 cases) was inhaled 8 % sevoflurane, then given sacral block anesthesia. The anesthetic effect of sevoflurance combined with sacral block anesthesia in treatment of pediatric hernia surgery was evaluated by vital sign, induction time, recovery time, anesthesia time, Pediatric anesthesia emergence delirium(PAED). Induction Compliance Checklist (ICC) score and adverse reactions during anesthesia. Results: At T1 and T2, the HR, MAP of two groups were higher than that of the T0(P<0.05). But there were no statistical significance on HR and MAP at T1 and T2(P>0.05). At T3, the level of HR, MAP was close to the value of T1. At 4 point of time, there were no statistical significance on SpO₂ between two groups (P>0.05). The induction time and recovery time of observation group was shorter than that of the control group (P<0.05). There were no statistical significance on anesthesia duration between two groups (P>0.05). The expected anesthesia time was achieved in two groups. The PAED and ICC scores of observation group were lower than that of the control group(P<0.05). There were no statistical significance on the incidence of adverse reactions between two groups(P>0.05). Conclusion: Sevoflurane anesthesia combined with sacral block anesthesia have good anesthesia effect on pediatric hernia surgery with short anesthesia induction, and the children can recover quickly and cooperate well with less postoperative agitation, worthy of clinical use.