硬膜外阻滞在小儿腹部手术中的应用

目的 :与全麻比较 ,评价小儿腹部手术时硬膜外阻滞的可行性。方法 :1 1 6例腹部手术患儿 ,随机分成两组 ,分别接受硬膜外麻醉 (Ⅰ组n =68)或全麻 (Ⅱ组n =48)。Ⅰ组在基础麻醉下行硬膜外置管 ,注入 0 .8%～ 2 %的利多卡因维持麻醉 ;Ⅱ组在快速诱导下气管插管 ,行静吸复合全麻。均常规监测呼吸、脉搏、血压、血氧饱和度及心电图。于不同时点分别抽取静脉血 5ml,测定肾素、血管紧张素、醛固酮及皮质醇的变化。记录术中肌紧张、鼓肠例数 ,观察术后恢复情况。结果 :Ⅰ组成功率达 98% ,无一例全脊麻发生 ,与Ⅱ组相比生命体征相对稳定、苏醒快。结论 :小儿硬膜外阻滞不仅镇痛完善、肌肉松弛、呼吸循环功能影响小 ,而且有利于患儿术后康复 ,一般情况尚好的患儿可积极选用。

Epidural Anesthesia in Children Undergoing Abdominal Surgery

ObjectiveTo evaluate the feasibility of epidural anesthesia in abdominal surgery in children by comparing with general anesthesia. Methods 116 children undergoing abdominal surgery were randomly divided into two groups and designed to receive epidural anesthesia (group I, n=68) or general anesthesia (group Ⅱ, n=48) . The children of group Iwere punctured and catheterized and put 0.8%～2% lidocaine into epidural cavity for anesthesia after being basal anesthesia. The others were endotracheal catheterized after being induced quickly for complex intravenous and inhalation anesthesia. Monitored the R?P?Bp?SpO 2 and ECG conventionally. Respectively, collected 5ml venous blood, in order to measure the variation of renin?angiotensin?aldosterone and cortisol in different moments. Recorded the numbers muscular tension and intestinal expansion during operation and the conditions of recovering. Result Being compared with group Ⅱ, in group I the rate of success was 98%, total spinal anesthesia didn't occur, the life sign was relatively stable and the children revived quickly. Conclusion The epidural anesthesia in children not only has more perfect analgesia and muscle relaxation. Less effect on respiration and circulation function, but also is of benefit to recovering during postoperation, and may be selected actively for children general condition is good.