氯普鲁卡因在小儿硬膜外麻醉中的应用

目的 研究氯普鲁卡因用于小儿硬膜外麻醉的可行性与最低有效浓度. 方法 60例在硬膜外复合全麻下行下腹部或会阴部手术的患儿,随机分为1％、1.5％和2％氯普鲁卡因组,每组20例.吸入七氟烷麻醉后行硬膜外穿刺,硬膜外腔分别注入相应浓度的氯普鲁卡因8～10 mg/kg.观察记录患儿各时间点的HR、NBP、RR、SpO2及麻醉效果、静脉麻醉药总量. 结果 C组患者的生命体征较A、B两组更平稳,C组的起效时间和疼痛消失时间短于其他两组,痛觉恢复时间长于其他两组,静脉麻醉药用量C组最小,差异有显著性. 结论 2％氯普鲁卡因用于儿童硬膜外麻醉较1.5％及1％浓度氯普鲁卡因维持时间长,麻醉期间基本不用追加静脉麻醉药,麻醉效果满意,无明显不良反应,是儿童硬膜外麻醉的最低有效浓度.

Epidural Anesthesia with Different Concentration of Chloroprocaine in Children

Objective To study the feasibility and the lowest effective concentration of chloroprocaine for epidural anesthesia in children.Methods 60 pediatric patients undergoing lower abdomen or perineal operation under epidural combined general anesthesia were randomly assigned to 1% chloroprocaine group,1.5% chloroprocaine group and 2% chloroprocaine group,with 20 cases each.The patients all received epidural puncture after inspiring sevoflurane,and corresponding concentration of chloroprocaine 8~10 mg/kg were injected into epidural space.HR,NBP,RR,SpO2,the anesthetic effect,and the total amount of intravenous anesthetics were observed and recorded.Results Comparing with group A and B,the vital signs in group C were more stable;the onset time and the analgesia time was more shorter and the algesthesia recovery time was longer;the dose of intravenous anesthetics in group C was least.The differences were significant.Conclusion 2% chloroprocaine for epidural anesthesia in children retains a longer anaesthesia time than the concentration of 1.5% and 1% chloroprocaine.There is no need to boost intravenous anesthetics.The anesthesia effects is satisfactory and without any obviously adverse effect.It is the lowest effective concentration for epidural anesthesia in children.