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超声引导头皮神经阻滞在儿童颅骨缝重建麻醉中的应用。

Ultrasound-guided scalp nerve block in anesthesia of children receiving cranial suture reconstruction.

机构信息

Department of Anesthesiology, Children's Hospital of Shanghai, Shanghai, China.

Department of SICU, Children's Hospital of Shanghai, Shanghai, China.

出版信息

BMC Anesthesiol. 2023 Aug 1;23(1):258. doi: 10.1186/s12871-023-02223-9.

Abstract

OBJECTIVE

Analgesia is very important for children with craniosynostosis who are undergoing cranial suture reconstruction. This study investigated the effectiveness and safety of an analgesic technique based on scalp nerve block combined with general anesthesia versus general anesthesia alone.

METHODS

This was a single-center, prospective, randomized, controlled study. A total of 60 children aged 6-24 months who underwent cranial suture reconstruction were randomly divided into two groups: Group A (general anesthesia combined with scalp nerve block) and Group N (general anesthesia). The hemodynamics were recorded preoperatively, at 5 min after incision and at 1, 6 and 12 h after surgery; the pain was scored at 1, 6 and 12 h after surgery, and blood glucose was detected at 1 h after surgery.

RESULTS

The mean arterial pressure and heart rate at 5 min after incision and 1 h after surgery in Group N were higher than those in Group A; the blood glucose and FLACC score in Group N were higher than those in Group A; and the number of postoperative analgesic pump presses were also significantly increased in Group N.

CONCLUSION

Preoperative scalp nerve block can reduce hemodynamic fluctuation and postoperative pain in children undergoing cranial suture reconstruction for craniosynostosis. Thus, it can be safely and effectively applied in the anesthesia of these children.

摘要

目的

对于接受颅缝重建的颅缝早闭患儿,镇痛非常重要。本研究旨在探讨基于头皮神经阻滞联合全身麻醉与单纯全身麻醉的镇痛技术的有效性和安全性。

方法

这是一项单中心、前瞻性、随机、对照研究。共纳入 60 例年龄在 6-24 个月行颅缝重建的患儿,随机分为两组:A 组(全身麻醉联合头皮神经阻滞)和 N 组(全身麻醉)。记录术前、切皮后 5min 及术后 1、6、12h 的血流动力学;术后 1、6、12h 进行疼痛评分,并于术后 1h 检测血糖。

结果

N 组切皮后 5min 和术后 1h 的平均动脉压和心率高于 A 组;N 组的血糖和 FLACC 评分高于 A 组;N 组术后镇痛泵按压次数也明显增加。

结论

术前头皮神经阻滞可减少颅缝早闭患儿行颅缝重建术的血流动力学波动和术后疼痛,可安全有效地应用于此类患儿的麻醉中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a88b/10391876/f2c8f40a714a/12871_2023_2223_Fig1_HTML.jpg

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