期刊文献+

骶管麻醉与吸入七氟醚麻醉在婴儿肛周脓肿手术中的对比分析 被引量:2

Comparision of Caudal Block and Total Inhalation Anesthesia by Sevoflurane on Perianal Abscess Surgery in Infants
下载PDF
导出
摘要 目的:比较骶管阻滞麻醉和全凭吸入七氟醚麻醉在婴儿肛周脓肿手术中的应用效果。方法选取行肛周脓肿手术的婴儿49例,随机分为骶管阻滞组( C组)24例,全凭吸入七氟醚组( S组)25例。 C组采用0.5%~0.8%利多卡因复合0.15%罗哌卡因(0.5 mL/kg)行骶管阻滞,S组吸入3%~4%七氟醚行全身麻醉。记录两组患儿麻醉诱导前(T0)、麻醉诱导后(T1)、手术开始时(T2)和手术结束后(T3)各时点的心率(HR)、血压(BP)、呼吸(R)和脉搏血氧饱和度( SpO 2)等。记录两组患儿麻醉起效时间、喉痉挛发生率及麻醉苏醒期躁动评分。结果两组患儿麻醉起效时间、T0和T1时点的HR、BP、R和SpO2未见明显差异( P>0.05)。与C组相比,S组患儿T2和T3时间点的HR、R,喉痉挛发生率、麻醉苏醒期躁动评分明显升高( P<0.05)。结论与全凭吸入七氟醚麻醉相比,骶管阻滞对患儿生理干扰更小、镇痛更完善、麻醉苏醒期更安静。因此骶管阻滞更适合用于婴儿肛周脓肿手术的麻醉。 Objective To compare the effects of caudaI bIock and totaI inhaIation anesthesia by sevofIurane on perianaI abscess surgery in infants.Methods A totaI of 50 infants scheduIed to undergo perianaI abscess surgery were randomIy divided into two groups with twenty five in each.Infants in caudaI bIock group (C group) were conducted caudaI bIock using Iidocaine 0.5%-0.8%compound ropivacaine 0.15%,the totaI voIume of Iidocaine and ropivacaine was 0.5 mL/kg.Infants in totaI inhaIation anesthesia group ( S group) were conducted generaI anesthesia by sevofIurane 3%~4%.VitaI signs such as eIectrocardiography, non-invasive bIood pressure, re-spiratory rate and puIse oxygen saturation were recorded at the time of before anesthesia in-duction (T0),after anesthesia induction ( T1),at the beginning of operation ( T2) and at the end of operation ( T3 ) .The anesthesia onset time, the incidence of Iaryngospasm and emer-gence agitation score were recorded.Results There were no significant differences in anesthesia onset time,heart rate, non-invasive bIood pressure, breathing and puIse oxygen saturation at the time point T0 and T1 between the two groups (P〉0.05).Compared with those in S group, heart rate and breathing were more stabIe at the time point T2 and T3,and the incidence of Ia-ryngospasm were aIso significantIy reduced in C group ( P〈0.05) .Moreover,the emergence agi-tation score in C group was Iower as compared with S group ( P〈0.05 ) .Conclusion Compared with totaI inhaIation anesthesia by sevofIurane, caudaI bIock generates Iess physioIogicaI dis-turbances,provides better anaIgesia and infants with caudaI bIock are more equiIibrium in anes-thesia recovery period.Therefore,caudaI bIock is more suitabIe for abscess surgery in infants.
作者 王华 袁作芝
出处 《湖北民族学院学报(医学版)》 2015年第3期43-45,49,共4页 Journal of Hubei Minzu University(Medical Edition)
关键词 骶管阻滞 七氟醚 喉痉挛 婴儿 caudaI block sevofIurane Iaryngospasm infant
  • 相关文献

参考文献13

  • 1Hu S, Dong HL, Sun YY, et al. Anesthesia with sevoflu- rane and remifentanil under spontaneous respiration assis- ted with high-frequency jet ventilation for tracheobronchi- al foreign body removal in 586 children [ J ] .Paediatr An- aesth,2012, 22(11) :1 100-1 104.
  • 2Shin KM, Park JH, Kil HK, et al. Caudal epidural block in children: comparison of needle insertion parallel with caudal canal versus conventional two-step technique [ J ]. Anaesth Intensive Care,2010,38 (3) : 525- 529.
  • 3Sethi S, Ghai B, Ram J, et al.Postoperative emergence de- lirium in pediatric patients undergoing cataract surgery-- a comparison of desflurane and sevoflurane [ J ]. Paediatr Anaesth,2013,23(12) :1 131-1 137.
  • 4冉隆青,彭明清.全凭吸入七氟醚麻醉在小儿手术中的应用[J].重庆医学,2010,39(11):1434-1435. 被引量:15
  • 5Zhang C, Hu J, Liu X, et al.Effects of intravenous dexme- detomidine on emergence agitation in children under sevoflurane anesthesia: a meta- analysis of randomized controlled trials[J].PLoS 0ne,2014,9(6) :99718.
  • 6Zhu M, Wang H, Zhu A, et al. Meta- analysis of dexme- detomidine on emergence agitation and recovery profiles in children after sevoflurane anesthesia: different admin- istration and different dosage [ J ]. PLoS One, 2015, 10 (4) .123728.
  • 7Sun L, Guo R, Sun L. Dexmedetomidine for preventing sevoflurane-related emergence agitation in children:a me- ta-analysis of randomized controlled trims [ J ]. Acta An- aesthesiol Scand,2014,58(6) :642-650.
  • 8Sato M ,Shirakami G,Tazuke-Nishimura M ,et al.Effect of single-dose dexmedetomidine on emergence agitation and recovery profiles after sevoflurane anesthesia in pediatric ambulatory surgery [ J ]. J Anesth, 2010,24 (5) : 675- 682.
  • 9Negargar S, Peirovifar A, Mahmoodpoor A, et al. Hemody- namic parameters of low-flow isoflurane and low- flow sevoflurane anesthesia during controlled ventilation with laryngeal mask airway[ J] .Anesth Pain Med, 2014,4(5) : 20 326.
  • 10Knapp J, Bergmann G, Bruckner T, et al.Pre- and post- conditioning effect of Sevoflurane on myocardial dysfunc- tion after cardiopulmonary resuscitation in rats [J].Re-suscitation ,2013,84(10) : 1 450-1 455.

二级参考文献35

  • 1孙艳红,崔湧,王俊科.七氟醚对内毒素诱导大鼠肺组织氧化应激反应的影响[J].中华麻醉学杂志,2006,26(8):735-737. 被引量:34
  • 2Tobias JD.Sevoflurane for controlled hypotension during spinal surgery:prolininary experence in five adolescents[J].Pediatric Anaesth,1998,8:167.
  • 3Sarner JB,Levine M,Davis PJ,et al.CIinical characteristics of sevoflurane in children.A comparison with halothane[J].Anesthesiology,1995,82:38.
  • 4Piat V,Dubois MC,Johanet S,et al.Induction and recovery characteristics and hemodynamie responses to sevoflurane and halothane in children[J].Anesth Analg,1994,79:840.
  • 5Tomoki Nishiyama.Hemodynamic and catecholamine response to a rapid increase in is of lurane or sevoflurane concentration during a maintenance phase of anesthesia in humans[J].Anesth,2005,19:213.
  • 6Lrman J,Sikich N,Kleinman S,et al.The pharmacology of sevoflurane in infants and children[J].Anesthesiology,1994,80:814.
  • 7Cravero J,Surgeon S,Whalen W.Emergence agitation in paediatrie patients after sevoflurane anaethesia and no surgery:A comparion with halothane[J].Paediatr Anaesth,2000,10:419.
  • 8Machotta A.Anesthetic management of pediatric cleft lip and cleft palate repair[J].Anaestheology,2005,54:455.
  • 9SIDDIQUI MN, SIDDIQUI ZA. Systematic review and meta-anal-ysis of intmopemtive versus preoperative endoscopic sphincteroto-my in patients with gallbladder and suspected common bile ductstones[J]. Br J surg, 2012,99(1): 144.
  • 10CHINNERY GE, KRIGE JE, BORNMAN PC, et al. Endoscopicmanagement of bile leaks after laparoscopic cholecystectomy [J].S Afr J Surg, 2013, 51(4): 116-121.

共引文献41

同被引文献7

二级引证文献3

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部