超声引导下髂腹下-髂腹股沟神经阻滞在小儿腹股沟区手术中的应用

目的 分析超声引导下髂腹下-髂腹股沟神经阻滞麻醉在小儿腹股沟区手术中的应用效果.方法 将收治的84例行腹股沟手术的患儿随机分为观察组和对照组,每组42例.对照组患儿行单纯的全身麻醉,观察组患儿行超声引导下髂腹下-髂腹股沟神经阻滞麻醉.记录两组患儿人手术室时（T0）、手术切皮时（T1）及苏醒时（T2）三个时点的平均动脉压（MAP）、心率（HR）和血氧饱和度（SpO2）变化情况;观察两组患儿的手术时间,清醒时间,氯胺酮、丙泊酚总用量以及麻醉不良反应的发生率.结果 观察组HR、SpO2和MAP在各时点比较差异无统计学意义（P＞0.05）,而对照组HR、MAP在T1和T2时点明显高于T0（P＜0.05）;观察组HR、MAP在T1和T2时点均低于对照组（P＜0.01）.两组手术时间比较差异无统计学意义（P＞0.05）;观察组患儿的麻醉清醒时间短于对照组（P＜0.01）;氯胺酮、丙泊酚总用量均少于对照组（P＜0.01）.观察组患儿术中体动、术后躁动及恶心呕吐的不良反应发生率显著低于对照组（P ＜0.05或0.01）.两组呼吸抑制发生率比较差异无统计学意义（P＞0.05）.结论 相较于传统全身麻醉,在小儿腹股沟区手术中应用超声引导下髂腹下-髂腹股沟神经阻滞麻醉不仅能更好地保证患儿心率、呼吸、循环的稳定,且患儿苏醒快、静脉麻醉药物使用剂量小,并发症少.

Application of ultrasound-guided ilioinguinal/iliohypogastric nerve block in surgery on pediatric inguinal region

Objective To analyze the application effect of uhrasound-guided ilioinguinal/iliohypogastric nerve block an- esthesia in surgery on pediatric inguinal region.Methods 84 children undergoing inguinal region surgery were ramdomly di- vided into observation group and control group with 42 eases in each group.The control group were given general anesthesia （GA） only, while the observation group were given ultrasound-guided ilioinguinal/iliohypogastric nerve block anesthesia. Then, the mean arterial pressure（MAP） ,heart rate（HR） and blood oxygen saturation（ SpO2 ） at the time of entering the operating room（ TO ）, skin incision （ T1 ） and waking up （ T2 ） of both groups were recorded.Meanwhile, duration of operation, time of waking up ,total amount of ketamine and propofol and incidence of adverse reactions caused by anesthesia were observed.Results There was no significant statistical difference in HR,SpO2 and MAP at each time point of the observation group（ P 〉0. 05） ,but the HR and MAP of the control group at T1 and T2 were significantly higher than those at To（ P 〈 0. 05） ;the HR and MAP of the observation group at T1 and T2 were significantly lower than those of the control group at the same time points（ P 〈0. 01 ）.The difference of operation duration of both groups were not statistically significant（ P 〉0.05） ; The time of coming back to life of the observation group was obviously shorter than that of the control group（ P 〈0.01 ） ,and the total amount of ketamine and propofol were also less than those of the control group（ P 〈0. 01 ）.Incidence of adverse events including movement during operation, postoperative agitation and pernicious vomiting of the observation group was significantly lower than that of the control group（ P 〈0.05 or 0.01 ） .Difference of respiratory depression ,however,were not statistically significant between two groups（ P 〉0.05）.Conclusion Comparing with traditional general anesthesia, ultrasoundguided ilioinguinal/il