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髂筋膜间隙阻滞联合喉罩全麻对小儿股骨骨折手术的影响:一项随机试验

Effects of fascia iliaca compartment block combined with general laryngeal mask airway anesthesia in children undergoing femoral fracture surgery: a randomized trial.

作者信息

Zhong H Y, Deng X B, Wang Z

机构信息

Department of Anesthesiology, Huadu District People's Hospital, Southern Medical University, Guangzhou 510800, Guangdong China.

Department of General Surgery, The People's Hospital of Xiaochang, Xiaogan 432900, Hubei, China.

出版信息

J Pain Res. 2018 Nov 8;11:2821-2826. doi: 10.2147/JPR.S177122. eCollection 2018.

Abstract

BACKGROUND

Postoperative agitation after general anesthesia is a common complication in children; however, pain or uncomfortable feeling is the main reason of emergence agitation. Here, we have investigated the effects of fascia iliaca compartment block (FICB) combined with general laryngeal mask airway (LMA) anesthesia in children undergoing femoral surgery.

METHODS

Eighty children undergoing femoral surgery were randomly divided into two groups: FICB + LMA group and control group (n=40). The FICB + LMA group received FICB combined with general LMA anesthesia, and the control group received tracheal intubation general anesthesia alone. Anesthesia was maintained with nitrous oxide and sevoflurane. Hemodynamic parameters were monitored, and pain was assessed by verbal numeric score within 24 hours postoperatively. Time to extubation, time to discharge from the postanesthesia care unit and postoperative complications were recorded.

RESULTS

Hemodynamic parameters were more stable in the FICB + LMA group than in the control group during anesthesia induction (<0.05). Verbal numeric score values were lower in the FICB + LMA group than in the control group at 2-8 hours postoperatively (>0.05). Compared with the control group, the time to extubation and time to discharge from postanesthesia care unit were shorter in the FICB + LMA group (<0.05). Additionally, postoperative complications were less in the FICB + LMA group.

CONCLUSION

The FICB combined with general LMA anesthesia may provide intra- and postoperative analgesia, shorten emergence time and reduce postoperative agitation in children undergoing femoral surgery.

TRIAL REGISTRATION

This study is registered at http://www.chictr.org.cn (registration number: ChiCTR-IOR-17012725).

摘要

背景

全身麻醉后小儿躁动是常见并发症;然而,疼痛或不适感是苏醒期躁动的主要原因。在此,我们研究了髂筋膜间隙阻滞(FICB)联合喉罩气道(LMA)全身麻醉在小儿股骨手术中的效果。

方法

80例接受股骨手术的小儿随机分为两组:FICB + LMA组和对照组(n = 40)。FICB + LMA组接受FICB联合LMA全身麻醉,对照组仅接受气管插管全身麻醉。采用氧化亚氮和七氟醚维持麻醉。监测血流动力学参数,并在术后24小时内通过言语数字评分法评估疼痛程度。记录拔管时间、麻醉后监护病房出院时间及术后并发症。

结果

麻醉诱导期间,FICB + LMA组的血流动力学参数比对照组更稳定(<0.05)。术后2 - 8小时,FICB + LMA组的言语数字评分值低于对照组(>0.05)。与对照组相比,FICB + LMA组的拔管时间和麻醉后监护病房出院时间更短(<0.05)。此外,FICB + LMA组的术后并发症更少。

结论

FICB联合LMA全身麻醉可为接受股骨手术的小儿提供术中和术后镇痛,缩短苏醒时间并减少术后躁动。

试验注册

本研究已在http://www.chictr.org.cn注册(注册号:ChiCTR-IOR-17012725)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a96f/6235337/6746192eb33d/jpr-11-2821Fig1.jpg

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