腰-硬联合麻醉在小儿下肢手术的应用

目的:讨论小儿下肢手术硬膜外麻醉和腰-硬联合麻醉对患儿阻滞深度和血流动力的影响.方法:对60例手术患儿随机分成两组:A组穿刺针进入蛛网膜下腔后,即注入0.5％罗派卡因液0.5～1.0ml(0.25 mg/kg),术中按需追加1.0％利多卡因和0.375％罗派卡因混合液.B组患儿穿刺针进入硬膜外腔后,然后注入2.0％利多...

The application of combined spinal-epidural anesthesia in pediatric lower extremity operation

Objective: To discuss block depth and hemodynamic effects of epidural anesthesia and combined spinal-epidural anesthesia on the operation of lower limb in children. Methods: 60 cases of operation were randomly divided into two groups.In group A,puncture needle into the subarachnoid space,namely the infusion of 0.5% ropivacaine solution 0.5-1.0ml(0.25mg/kg),intraoperative required an additional 1% lignocaine and 0.375% ropivacaine mixture.In B group,the puncture needle into the epidural space,then 2% Lidocaine Injected in the epidural cavity 2ml.In 5-10 minutesinjection of 1% lidocaine and ropivacaine mixed 5-8ml 0.375%.Intraoperative additional medication with group A,the general for the first volume of 1/2-1/3.With acupuncture anesthesia plane and block time determination. Results: Hyperalgesia block plane bound up to T8 times in group A were significantly shorter in group B(P<0.01).A group of local anesthetic dosage was obviously less than group B(P<0.01).In group A muscle relaxants rate of satisfaction was 93.3%,67% in B group.All patients of A group were treated with an unused ketamine aggrandizement,only 2 cases with additional force on the West 1.0mg.7 cases in group B on analgesic intolerance,8 cases of visceral traction reaction obviously,15 cases patients had intermittent bolus to postoperative ketamine. Conclusion: lumbar-epidural anesthesia combined anesthesia than fast onset of effect,circulation,complete block.