摘要
目的 :研究骶管阻滞用于小儿腹腔镜手术的麻醉效果及对呼吸循环的影响。方法 :选择 6岁以下ASAⅠ～Ⅱ级 38例患者于腹腔镜下行阑尾切除术、斜疝疝囊腹壁内环口高位结扎术 ,采用氯胺酮基础麻醉下行单次骶管阻滞 ,注入 0 6 %～ 1 0 %利多卡因 1 0～ 1 5ml kg。术中酌情辅助安定和 或芬氟合剂 ,观察麻醉效果 ,对照观察麻醉及气腹前后呼吸循环功能的改变。结果 :患者均镇痛充分 ,术中腹壁肌松良好 32例(84 2 % ) ,气腹后 1 0min潮气量显著下降 ,呼吸频率显著增加 (P <0 .0 1 ) ,而每分钟通气量及SpO2 无显著改变 ;气腹后 30min ,由于机体代偿性自身调节作用 ,呼吸功能显著改善。术中平均动脉压 (MAP)及心率 (HR)无显著变化 ,部分病例在骶管阻滞、气腹、辅助用药时血压下降明显 ,加快补液或静注麻黄碱后保持了循环稳定。结论 :0 6 %～ 1 0 %利多卡因 1 0～ 1 5ml kg单次骶管阻滞用于小儿腹腔镜手术麻醉 ,效果确切 。
Objective:To study the anesthesia effects and the affects on respiration and circulation of caudal block during laparoscopy of children .Methods:38 patients(ASA?Ⅰ Ⅱ) accepted appendectomy and ligation of inner ring of the oblique hernia under laparoscopy were selected.Single caudal block under basal anesthesia of ketamine was adopted,injecting 0.6% 1.0% lidocaine 1.0 1.5ml/kg,diazepam or INOWA added according to operation condition.The anesthesia effects and the respiration and circulation function were observed before and after anesthesia or aeroperitonia.Results:Sufficient analgesia in all cases,32 cases received good muscle relaxation of abdominal wall,10min after aeroperitonia,VT significantly decreased and RR increased significantly,but VE and SpO 2 had no marked changes.MAP and HR had no significant changes during operation,some cases need fast liquid or ephedrine injecting because of marked low blood pressure when caudal blocking ,aeroperitonia or aid drugs added.Conclusions:Single caudal block of 0.6% 1.0% lidocaine 1.0 1.5ml/kg has firmly effects on the laparoscopy and meets the operations needs.
出处
《腹腔镜外科杂志》
2004年第1期45-46,共2页
Journal of Laparoscopic Surgery
