超声引导下腹横平面阻滞联合氯胺酮麻醉与单纯氯胺酮麻醉用于小儿腹股沟疝手术的临床效果

目的探讨超声引导下腹横平面阻滞联合氯胺酮麻醉与单纯氯胺酮麻醉用于小儿腹股沟疝手术的效果及安全性。 方法选择2018年9月至2020年3月川北医学院附属医院收治的80例腹股沟疝患儿作为研究对象，并按照麻醉方案的不同将患者分为观察组与试验组，每组患儿40例。观察组的麻醉方案为单纯氯胺酮静脉麻醉；试验组的麻醉方案为超声引导下腹横平面阻滞联合氯胺酮麻醉。对比2组患儿不同时间点切皮前（T0）、切皮后10 min（T1）、切皮后15 min（T2）、探查疝囊（T3）]的生命体征、麻醉质量以及进入麻醉恢复室后不同时间点进入即刻（T4）、进入后20 min（T5）、进入后40 min（T6）]的疼痛情况和镇静情况，及2组患儿的不良反应情况。 结果试验组患儿T1、T2、T3时心率、平均动脉压均显著低于观察组患儿（P<0.05）；2组患儿麻醉诱导时间对比，差异无统计学意义（P>0.05）；试验组苏醒时间均显著低于观察组患儿（P<0.05）；试验组患儿T4、T5、T6时东安大略儿童医院疼痛量表评分、Watcha镇静评分均显著低于观察组患儿（P<0.05）；试验组患儿的不良反应发生率显著低于观察组患儿（P<0.05）。 结论超声引导下腹横平面阻滞联合氯胺酮麻醉对小儿腹股沟疝手术的麻醉效果显著，其麻醉方案不仅能获得更稳定的需流动力学特征，缩短患儿的麻醉苏醒时间，还能改善患儿术后的疼痛及镇静情况。

Clinical effect of ultrasound-guided transverse abdominal plane block combined with ketamine anesthesia and ketamine anesthesia alone in pediatric inguinal hernia surgery

ObjectiveTo investigate the efficacy and safety of ultrasound-guided transversal abdominal block combined with ketamine anesthesia and ketamine anesthesia alone in children with inguinal hernia surgery. MethodsFrom September 2018 to March 2020, 80 children with inguinal hernia who were admitted to the Affiliated Hospital of North Sichuan Medical College were selected as the research subjects, and the patients were divided into observation group and experimental group according to different anesthesia plans, with 40 children in each group. example. The anesthesia plan of the observation group was intravenous ketamine anesthesia alone; the anesthesia plan of the experimental group was ultrasound-guided lower abdominal transverse plane block combined with ketamine anesthesia. The vital signs, anesthesia quality and entry into anesthesia were compared between the two groups at different time points before skin incision (T0), 10 minutes after skin incision (T1), 15 minutes after skin incision (T2), and exploration of hernia sac (T3)]. Pain and sedation at different time points after the recovery room immediately after entering (T4), 20 minutes after entering (T5), and 40 minutes after entering (T6)], as well as adverse reactions in the two groups. ResultsThe heart rate and mean arterial pressure at T1, T2, and T3 in the experimental group were significantly lower than those in the observation group (P<0.05); there was no significant difference in anesthesia induction time between the two groups (P>0.05). The recovery time of the experimental group was significantly lower than that of the observation group (P<0.05); the Eastern Ontario Children's Hospital pain scale score and Watcha sedation score at T4, T5 and T6 of the experimental group were significantly lower than those of the observation group (P<0.05). The incidence of adverse reactions in the experimental group was significantly lower than that in the observation group (P<0.05). ConclusionUltrasound-guided transverse abdominal plane block combined with ketamine anesthesia has a significant anesthesia effect on children with inguinal hernia surgery. The anesthesia scheme can not only obtain more stable fluid dynamic characteristics, shorten the recovery time of children from anesthesia, but also improve children's surgery. Pain and sedation.