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超声引导在小儿骶管阻滞中的作用。

The role of ultrasound guidance in pediatric caudal block.

作者信息

Erbüyün Koray, Açıkgöz Barış, Ok Gülay, Yılmaz Ömer, Temeltaş Gökhan, Tekin İdil, Tok Demet

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Celal Bayar University, Manisa, Turkey. E-mail.

出版信息

Saudi Med J. 2016 Feb;37(2):147-50. doi: 10.15537/smj.2016.2.13501.

Abstract

OBJECTIVES

To compare the time interval of the procedure, possible complications, post-operative pain levels, additional analgesics, and nurse satisfaction in ultrasonography-guided and standard caudal block applications.

METHODS

This retrospective study was conducted in Celal Bayar University Hospital, Manisa, Turkey, between January and December 2014, included 78 pediatric patients. Caudal block was applied to 2 different groups; one with ultrasound guide, and the other using the standard method.

RESULTS

The time interval of the procedure was significantly shorter in the standard application group compared with ultrasound-guided group (p=0.020). Wong-Baker FACES Pain Rating Scale values obtained at the 90th minute was statistically lower in the standard application group compared with ultrasound-guided group (p=0.035). No statistically significant difference was found on the other parameters between the 2 groups. The shorter time interval of the procedure at standard application group should not be considered as a distinctive mark by the pediatric anesthesiologists, because this time difference was as short as seconds.

CONCLUSION

Ultrasound guidance for caudal block applications would neither increase nor decrease the success of the treatment. However, ultrasound guidance should be needed in cases where the detection of sacral anatomy is difficult, especially by palpations.

摘要

目的

比较超声引导下与标准骶管阻滞应用在操作时间间隔、可能的并发症、术后疼痛程度、额外使用的镇痛药以及护士满意度方面的差异。

方法

这项回顾性研究于2014年1月至12月在土耳其马尼萨的切拉尔·拜亚尔大学医院进行,纳入了78例儿科患者。将骶管阻滞应用于2个不同的组;一组采用超声引导,另一组采用标准方法。

结果

与超声引导组相比,标准应用组的操作时间间隔显著更短(p=0.020)。在第90分钟时,标准应用组获得的面部表情疼痛评分量表值在统计学上低于超声引导组(p=0.035)。两组在其他参数上未发现统计学上的显著差异。标准应用组操作时间间隔较短这一点,儿科麻醉医生不应将其视为一个显著标志,因为这个时间差异短至数秒。

结论

骶管阻滞应用中的超声引导既不会增加也不会降低治疗的成功率。然而,在骶骨解剖结构难以检测,尤其是通过触诊难以检测的情况下,应需要超声引导。

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