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超声引导下连续骶管阻滞在小儿腹腔镜手术全面骶管扫描后的应用:一项前瞻性、随机、双盲研究

Application of Continuous Sacral Block Guided by Ultrasound After Comprehensive Sacral Canal Scanning in Children Undergoing Laparoscopic Surgery: A Prospective, Randomized, Double-Blind Study.

作者信息

Yan Ting-Ting, Yang Xin-Lu, Wang Shan, Chen Jia-Qi, Hu Ji-Cheng, Zhou Ling, Gao Wei

机构信息

Department of Anesthesiology, First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, Hefei, Anhui, 230001, People's Republic of China.

出版信息

J Pain Res. 2023 Jan 10;16:83-92. doi: 10.2147/JPR.S391501. eCollection 2023.

Abstract

PURPOSE

The present study aimed to explore the effects of continuous sacral block on the postoperative pain of children and the satisfaction of the nurses in post-anesthesia care unit (PACU). Also, the influence of the modified protocol of continuous sacral block was investigated.

PATIENTS AND METHODS

A total of 60 children undergoing laparoscopic surgery were randomly divided into two groups: GI and GC groups. The general anesthesia was induced with midazolam, propofol, sufentanil and succinylcholine in both groups. In addition, the patients were subjected to continuous sacral block with levobupivacaine in group GC. The modified protocol of continuous sacral block was divided into three steps: comprehensive lumbar and sacral vertebral canal scanning by ultrasound, catheterization and administration. The EVENDOL pain scales and pediatric anesthesia emergence delirium scales of the children were evaluated at 5 min after extubation (T), 90 min (T), and 4 h (T) after the operation. The nurses' satisfaction scores at T -T and adverse events, such as nausea and vomiting, were also recorded, after the operation.

RESULTS

After ultrasonic scanning, one patient in group GC was excluded due to the sacral hiatus atresia, which might lead to failure of catheterization. Data of 59 patients were collected for statistical analysis. Compared to the GI group, the EVENDOL scores and the pediatric anesthesia emergence delirium scales were reduced at T, T, and T ( < 0.05) in group GC. Furthermore, there was a higher rank of PACU nurses' satisfaction in the GC group compared to the GI group ( < 0.05).

CONCLUSION

Based on the modified protocol, continuous sacral block provides reliable and safety analgesia for children undergoing laparoscopic surgery, thereby improving the satisfaction of PACU nurses.

摘要

目的

本研究旨在探讨连续骶管阻滞对儿童术后疼痛及麻醉后护理单元(PACU)护士满意度的影响。同时,研究改良连续骶管阻滞方案的影响。

患者与方法

总共60例接受腹腔镜手术的儿童被随机分为两组:GI组和GC组。两组均使用咪达唑仑、丙泊酚、舒芬太尼和琥珀酰胆碱诱导全身麻醉。此外,GC组患者接受左旋布比卡因连续骶管阻滞。改良连续骶管阻滞方案分为三个步骤:超声全面扫描腰骶椎管、置管和给药。在拔管后5分钟(T1)、术后90分钟(T2)和4小时(T3)评估儿童的EVENDOL疼痛量表和小儿麻醉苏醒期谵妄量表。术后还记录了T1 - T3时护士的满意度评分以及恶心、呕吐等不良事件。

结果

超声扫描后,GC组有1例患者因骶裂孔闭锁被排除,这可能导致置管失败。收集59例患者的数据进行统计分析。与GI组相比,GC组在T1、T2和T3时的EVENDOL评分和小儿麻醉苏醒期谵妄量表评分降低(P < 0.05)。此外,与GI组相比,GC组PACU护士的满意度更高(P < 0.05)。

结论

基于改良方案,连续骶管阻滞为接受腹腔镜手术的儿童提供了可靠且安全的镇痛效果,从而提高了PACU护士的满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/724e/9840437/0141ae020b59/JPR-16-83-g0001.jpg

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