Kokki H, Hendolin H, Vainio J, Partanen J
Abteilung für Anaesthesie, Universitätszentralkrankenhaus Kuopio, Finnland.
Anaesthesist. 1992 Dec;41(12):765-8.
Forty patients aged 2 to 5 years who were admitted for paediatric operations were randomly assigned to have either spinal or general anaesthesia. Spinal anaesthesia was achieved with isobaric bupivacaine 0.5% at a dose of 0.5 mg/kg. General anaesthesia was induced with thiopentone 2-5 mg/kg and continued with low-dose fentanyl (1-2 micrograms/kg, oxygen/nitrous oxide/isoflurane (30/70/0.1-0.5%), vecuronium normoventilating the patients. The time spent in the operation room was shorter in the spinal anaesthesia group because the children were awake and could immediately be transferred. The haemodynamic pattern and respiratory function were stable during spinal anaesthesia. After general anaesthesia, respiratory function deteriorated as indicated by arterial desaturation (< 90%), which was detected in 11 of the 20 patients after general anaesthesia. Vomiting (2), sore throat (4) and micturition difficulties (2) were the adverse events associated with general anaesthesia. Three patients were restless after spinal anaesthesia. It can be concluded that spinal anaesthesia is a suitable anaesthetic technique for paediatric surgery.
40名年龄在2至5岁之间因小儿手术入院的患儿被随机分配接受脊髓麻醉或全身麻醉。脊髓麻醉采用0.5%等比重布比卡因，剂量为0.5毫克/千克。全身麻醉诱导采用硫喷妥钠2 - 5毫克/千克，随后持续给予低剂量芬太尼（1 - 2微克/千克）、氧气/氧化亚氮/异氟烷（30/70/0.1 - 0.5%）以及维库溴铵，使患者正常通气。脊髓麻醉组在手术室的停留时间较短，因为患儿保持清醒且可立即转运。脊髓麻醉期间血流动力学模式和呼吸功能稳定。全身麻醉后，呼吸功能恶化，表现为动脉血氧饱和度降低（<90%），全身麻醉后的20名患者中有11名出现此情况。呕吐（2例）、咽痛（4例）和排尿困难（2例）是与全身麻醉相关的不良事件。3名患者在脊髓麻醉后出现躁动。可以得出结论，脊髓麻醉是小儿外科手术合适的麻醉技术。
