Department of Anesthesiology, Bnai Zion Medical Center, the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa 32000, Israel.
J Clin Anesth. 2012 Sep;24(6):439-45. doi: 10.1016/j.jclinane.2012.02.004. Epub 2012 Jul 2.
To assess the rate of restoration of gastrointestinal (GI) function following combined spinal-epidural (CSE) anesthesia compared with general anesthesia in young infants undergoing elective intestinal surgery.
Prospective, randomized, controlled study.
Operating room and neonatal intensive care unit of a university hospital.
50 young infants undergoing elective intestinal surgery.
50 young infants were randomly allocated to two groups of 25 patients each, a general anesthesia group and a CSE anesthesia group. The two groups were further divided into two subgroups according to whether the surgical procedure was performed on the small or large intestine. The main outcome of this study was to measure the recovery times of GI function by determining the time to the first postoperative stool, duration of nasogastric feeding, and onset time of full enteral nutrition. The secondary outcome was to detect adverse events postoperatively.
Recovery of intestinal function was faster (P < 0.0001) and the frequencies of postoperative abdominal distension and pneumonia were less (P < 0.04) in infants who were anesthetized with CSE anesthesia than general anesthesia.
Combined spinal-epidural anesthesia leads to faster restoration of GI function while reducing adverse events in infants who require elective intestinal surgery.
评估在接受择期肠手术的婴幼儿中，与全身麻醉相比，联合脊髓-硬膜外麻醉（CSE）后胃肠道（GI）功能恢复的速度。
前瞻性、随机、对照研究。
大学医院的手术室和新生儿重症监护病房。
50 名接受择期肠手术的婴幼儿。
50 名婴幼儿随机分配到两组，每组 25 名患者，一组为全身麻醉组，一组为 CSE 麻醉组。这两组根据手术是在小肠还是大肠进行进一步分为两个亚组。本研究的主要结果是通过确定术后首次排便时间、鼻胃管喂养时间和全肠内营养开始时间来测量 GI 功能恢复的时间。次要结果是检测术后不良事件。
与全身麻醉相比，接受 CSE 麻醉的婴幼儿肠道功能恢复更快（P < 0.0001），且术后腹胀和肺炎的发生率更低（P < 0.04）。
在需要择期肠手术的婴幼儿中，联合脊髓-硬膜外麻醉可更快恢复 GI 功能，同时减少不良事件。
