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喉罩气道麻醉联合骶管阻滞在小儿麻醉中的应用

[Application of laryngeal mask airway anaesthesia combined with sacral canal block in pediatric anaesthesia].

作者信息

Shen Jie, Wang Fang

机构信息

Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang 110004, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2011 Jan;13(1):29-31.

PMID:21251383
Abstract

OBJECTIVE

To compare the advantages and disadvantages between laryngeal mask airway anaesthesia combined with sacral canal block and single tracheal tube anaesthesia in pediatric surgery.

METHODS

Sixty 2-12-year-old children for lower limb or lower abdominal surgery were randomly assigned into two groups: a group that was given laryngeal mask airway anaesthesia combined with sacral canal block and a group was given single tracheal tube anaesthesia (n=30 each). Mean arterial pressure (MAP), SpO₂ and heart rate (HR) were recorded before induction of anaesthesia, before and after insertion of laryngeal mask airway (LMA) or tracheal tube (TT) and after removal of LMA or TT. The waking-up time, VAS pain scores and the frequency of mania were recorded after surgery.

RESULTS

There were no significant differences in MAP, SpO₂ and HR between the combined and single anaesthesia groups before anaesthesia and insertion of LMA or TT, while the MAP and HR in the combined anaesthesia group were significantly lower than those in the single anaesthesia group after insertion and removal of LMA or TT (P<0.05). The VAS pain scores were significantly lower and the waking-up time was significantly shorter in the combined anaesthesia group than those in the single anaesthesia group (P<0.05) after surgery. The frequency of mania after surgery in the combined anaesthesia group was significantly lower than that in the single anaesthesia group (P<0.05).

CONCLUSIONS

The hemodynamics is more stable in children during the induction and the waking-time of laryngeal mask anesthesia combined with sacral canal block. The anesthesia may relieve postoperative pain, shorten the waking-up time and decrease the frequency of mania.

摘要

目的

比较喉罩气道麻醉联合骶管阻滞与单纯气管插管麻醉在小儿外科手术中的优缺点。

方法

将60例2 - 12岁行下肢或下腹部手术的患儿随机分为两组:一组给予喉罩气道麻醉联合骶管阻滞,另一组给予单纯气管插管麻醉(每组各30例)。记录麻醉诱导前、喉罩气道(LMA)或气管导管(TT)置入前后及LMA或TT拔除后的平均动脉压(MAP)、脉搏血氧饱和度(SpO₂)和心率(HR)。记录术后苏醒时间、视觉模拟评分(VAS)疼痛评分及躁动发生频率。

结果

联合麻醉组与单纯麻醉组在麻醉前及LMA或TT置入前的MAP、SpO₂和HR差异无统计学意义,而在LMA或TT置入及拔除后,联合麻醉组的MAP和HR显著低于单纯麻醉组(P<0.05)。术后联合麻醉组的VAS疼痛评分显著低于单纯麻醉组,苏醒时间显著短于单纯麻醉组(P<0.05)。联合麻醉组术后躁动发生频率显著低于单纯麻醉组(P<0.05)。

结论

喉罩麻醉联合骶管阻滞在小儿麻醉诱导和苏醒期血流动力学更稳定。该麻醉方式可减轻术后疼痛,缩短苏醒时间,降低躁动发生频率。

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Zhongguo Dang Dai Er Ke Za Zhi. 2011 Jan;13(1):29-31.
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