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右美托咪定麻醉联合阴茎背神经阻滞在小儿包皮环切术中的疗效

Efficacy of Dexmedetomidine Anesthesia plus Dorsal Penile Nerve Block in Pediatric Circumcision.

作者信息

Ji Ling, Yao Fan, Wang Yanwu, Li Caishun, Lin Yulong

机构信息

Department of Anaesthesiology, Central Hospital of Xiangyang, Xiangyang, Hubei 441021, China.

出版信息

Evid Based Complement Alternat Med. 2022 May 30;2022:1974131. doi: 10.1155/2022/1974131. eCollection 2022.

Abstract

OBJECTIVE

To assess the efficacy of dexmedetomidine anesthesia plus dorsal penile nerve block in pediatric circumcision.

METHODS

In this retrospective study, 80 children receiving circumcision in our hospital from February 2020 to February 2021 were recruited and assigned via different anesthesia methods at a ratio of 1 : 1 to receive dorsal penile nerve block plus dexmedetomidine anesthesia (combined anesthesia group) or only sevoflurane for total inhalational anesthesia (total anesthesia group). Traditional Chinese medicine (TCM) care was introduced to both groups of patients. Outcome measures included vital signs, operative indices, anesthesia effect, adverse reactions, parent satisfaction, and nursing satisfaction.

RESULTS

There were no significant differences in the heart rate, oxygen saturation, and mean arterial pressure between the two groups of children before anesthesia, after anesthesia, and during the awakening period ( > 0.05). Patients receiving combined anesthesia showed a shorter time lapse before the disappearance of eyelash reflex, longer time lapse before postoperative analgesic use, faster awakening, and shorter operation time and hospital stay versus those receiving total inhalational anesthesia alone ( > 0.05). The combined anesthesia resulted in a lower Induction Compliance Checklist (ICC) score, McGill score, and Richmond Agitation-Sedation Scale (RASS) score and a higher Ramsay score versus total anesthesia ( > 0.05). Patients receiving combined anesthesia showed a significantly lower incidence of adverse events (5.00% (2/40)) versus total inhalational anesthesia (62.50% (25/40)) (  = 29.574, > 0.05). The combined anesthesia group had a higher parent satisfaction (92.50% (37/40)) versus the total anesthesia group (75.00% (30/40)) (  = 4.501, > 0.05). A total of 80 questionnaires were distributed, with a 100% return rate and a 100% validity rate, and all 80 questionnaires scored 90 points or above. The families of children in both groups were satisfied with the quality of TCM care.

CONCLUSION

The efficacy of dorsal penile nerve block plus dexmedetomidine anesthesia in pediatric circumcision is better than total inhalational anesthesia with sevoflurane.

摘要

目的

评估右美托咪定麻醉联合阴茎背神经阻滞在小儿包皮环切术中的疗效。

方法

在这项回顾性研究中,选取2020年2月至2021年2月在我院接受包皮环切术的80例患儿,按照不同麻醉方法以1∶1的比例分为两组,分别接受阴茎背神经阻滞联合右美托咪定麻醉(联合麻醉组)或仅使用七氟醚进行全吸入麻醉(全麻醉组)。两组患者均采用中医护理。观察指标包括生命体征、手术指标、麻醉效果、不良反应、家长满意度和护理满意度。

结果

两组患儿麻醉前、麻醉后及苏醒期的心率、血氧饱和度和平均动脉压比较,差异均无统计学意义(>0.05)。与仅接受全吸入麻醉的患儿相比,接受联合麻醉的患儿睫毛反射消失前的时间更短,术后使用镇痛药前的时间更长,苏醒更快,手术时间和住院时间更短(>0.05)。联合麻醉组的诱导顺应性检查表(ICC)评分、麦吉尔评分和里士满躁动镇静量表(RASS)评分低于全麻醉组,而拉姆齐评分高于全麻醉组(>0.05)。与全吸入麻醉组(62.50%(25/40))相比,接受联合麻醉的患儿不良事件发生率显著更低(5.00%(2/40))(χ² = 29.574,>0.05)。联合麻醉组的家长满意度(92.50%(37/40))高于全麻醉组(75.00%(30/40))(χ² = 4.501,>0.05)。共发放80份问卷,问卷回收率和有效率均为100%,所有80份问卷得分均在90分及以上。两组患儿家属对中医护理质量均满意。

结论

阴茎背神经阻滞联合右美托咪定麻醉在小儿包皮环切术中的疗效优于七氟醚全吸入麻醉。

相似文献

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Circumcision in children with penile block alone.
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Implementation of an infant male circumcision programme, Pakistan.在巴基斯坦实施男性婴幼儿割礼项目。
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