复合髂腹下／髂腹股沟神经阻滞对小儿七氟烷麻醉后苏醒期的影响

目的观察髂腹下／髂腹股沟神经阻滞对门诊腹股沟区手术小儿七氟烷麻醉后苏醒期的影响。方法门诊拟行择期单侧腹股沟区手术的小儿60例，随机分为2组，组Ⅰ为全身麻醉组（n=30），组Ⅱ为全身麻醉联合INB组（n=30）。两组患儿均吸入七氟烷、笑气麻醉诱导，插入喉罩并保持自主呼吸。组Ⅰ患儿静脉注射芬太尼2～4μg·kg^-1，组Ⅱ患儿未使用静脉镇痛药，由同一麻醉医生实施骼腹股沟／髂腹下神经联合阻滞。两组患儿术中均以七氟烷、笑气维持麻醉。观察并记录：麻醉时间；入PACU后10min时的疼痛评分；PACU的滞留时间；PACU内发生躁动的患儿例数；局部麻醉部位有无血肿等并发症。结果入PACU后10min时组Ⅱ患儿的疼痛评分2．4±1．8，较组Ⅰ患儿的4．3±2．2为低，差异具有统计学意义，P〈0．05。组Ⅰ有6例，组Ⅱ有2例患儿发生了的严重的疼痛。组间比较差异无统计学意义。P〉0．05。组Ⅱ有2例（6．7％）患儿发生了躁动，较组Ⅰ10例（33．3％）为少，差异具有统计学意义。组Ⅱ患儿PACU的滞留时间为25±4min较组Ⅰ的31±3min为短，组间比较差异具统计学意义，P〈0．05。结论全麻联合髂腹下／髂腹股沟神经阻滞可为门诊行腹股沟区手术的小儿提供良好的镇痛并可降低七氟烷麻醉后EA的发生率，有利于此类小儿的围术期安全。

The effect of iliohypogastric/ilioinguinal nerve block on the emergence of sevoflurane anesthesia after ambulance surgery on lateral inguinal region of pediatric patients

OBJECTIVE To observe the effect of the iliohypogastric/ilioinguinal nerve block （INB） on the emergence after ambulance surgery on lateral inguinal region of pediatric patients with sevoflurane anesthsia. METHODS 60 pediatric patients who would accept selective ambulance surgery on lateral inguinal region were randomly allocated into two groups, one was general anesthesia group（Group Ⅰ ）, the other was combined anes- thesia group（Group Ⅱ ）, containing general anesthesia and INB. After induction of sevoflurane and nitrous oxide, laryngeal mask airway was used for maintaining airway while keeping spontaneous ventilation of the patients. Fentanyl 2-4μg·kg^-1 was injected for Group Ⅰ , while IHB was conduced by the same anesthesiologist for Group Ⅱ . The anesthesia was maintained by sevoflurane and nitrous oxide.The anesthesia time was accessed and the value of pain 10 min after being transferred into PACU was evaluated. The incidence of emergence agitation in PACU and the time staying in PACU were recorded. The side effects of local block such as hematoma, peritoneal injection were observed. RESULTS The score of pain in Group. Ⅰ （2.4 ＋ 1.8）, was significantly lower than that in Group Ⅱ （4.3＋2.2）, P〈0.05.6 patients in Group Ⅰ and 2 in Group Ⅱ were suffered fromsevere pain in PACU, but there are no statistical significance. There are significant differences of the incidence of EA between the two groups, 10 patients in Group I and 3 in Group Ⅱ demonstrated EA, respectively.The time staying in PACU of Group Ⅲ, 25± 4min, is significantly shorter than that of Group Ⅰ which is 31 ± 3min, P 〈 0.05.CONCLUSION INB can provide sufficient analgesia and decrease the incidence of EA after sevoflurane anesthesia for ambulance surgery on lateral inguinal region of pediatric patients, and thus ensure the safety of the postanaesthetic patients.