摘要
目的探讨头皮神经阻滞复合七氟醚在儿童钻孔引流手术中的应用。方法选择行钻孔引流术的患儿40例,分为头皮神经阻滞复合七氟醚组(A组)和七氟醚静吸复合麻醉组(B组)各20例。观察并记录麻醉诱导前、诱导后5min、切皮时、手术开始15min、手术结束时、术后30、120min的平均动脉压(MAP)、心率(HR)变化,并对清醒时间、术后恶心呕吐发生率、术后烦躁发生率及芬太尼用量进行比较。结果 B组切皮时、手术开始15min、手术结束时、术后30、120min,HR、MAP较术前明显升高(P<0.05),A组比B组清醒时间明显缩短(P<0.05),芬太尼用量明显减少,差异均有统计学意义(P<0.05)。B组术后出现哭闹16例,躁动14例发生率明显高于A组,差异有统计学意义(P<0.05)。结论七氟醚复合头皮神经阻滞用于小儿钻孔引流术的方法相对于单纯七氟醚静吸复合麻醉诱导、苏醒快,生命体征稳定,不良反应少,芬太尼用量少,用于小儿钻孔引流术具有很好的麻醉与术后镇痛效果、安全可行、简单有效。
Objective To study the application of nerve block scalp combined with sevoflurane in children drilling drainage oper- ation. Methods 40 children cases undergoing drilling drainage were selected and randomly divided into the scalp nerve block com- bined sevoflurane group（A,n= 20） and the sevoflurane intravenous inhalational combined anesthesia （B, n = 20）. The changes of H R and MAP before before induction and at 5 min after induction, skin incision, 15 rain after operation beginning, operation end, postoperative 30,120 min were observed and recorded. The awaking time,occurrence rate of postoperative nausea and vomiting,in- cidence rate of postoperative dysphoria and fentanyl dosage were compared between the two groups. Results HR,MAP at skin in- cision,15 rain after operation beginning,operation end, postoperative 30,120 min in the group B were significantly increased than before operation（P〈0.05） ; the awaking time in the group A was significantly shortened compared with the group B （P〈0.05）, the fentanyl dosage was significantly reduced （P〈0.05）; in the group B,crying and screaming appeared in 16 cases,dysphoria oc curred in 14 cases,the incidence rate was significantly higher than that in the group A（P〈0.05）. Conclusion Compared with sim- ple sevoflurane intravenous inhalational combined anesthesia,sevoflurane combined with scalp nerve block used in children drilling drainage operation has rapid induction and rapid awaking,stable vital signs, fewer adverse reactions,small fentanyl dosage and bet- ter anesthetic and postoperative analgesic effects, which is safe, feasible, simple and effective.
出处
《重庆医学》
CAS
CSCD
北大核心
2013年第26期3110-3111,共2页
Chongqing medicine
关键词
神经传导阻滞
引流术
七氟醚
儿童
nerve block
drainage
sevoflurane
children
drilling and drainage
