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目的:观察七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果。方法:选取80例行腹股沟疝气手术患儿,按随机数字表法分为两组,对照组(39例)静脉注射氯胺酮,观察组(41例)先吸入8%七氟醚,然后进行骶管阻滞麻醉,通过观察并记录两组患儿生命体征、麻醉诱导时间、苏醒时间、手术麻醉时间、苏醒期躁动评分(Pediatric anesthesia emergence delirium,PAED)和麻醉诱导期合作量表(Induction Compliance Checklist,ICC)及麻醉期间不良反应情况,评价七氟醚联合骶管阻滞麻醉对小儿疝气手术的麻醉效果。结果:两组切皮后T1、T2时心率(HR)、平均动脉压(MAP)水平均高于T0时的值(P<0.05),两组切皮后T1、T2时组间HR、MAP水平相比,无统计学差异(P>0.05)。两组切皮后T3时HR、MAP水平基本恢复到T0时的水平。两组切皮前后4个时间点的血氧饱和度(Sp O2)相比,无统计学差异(P>0.05)。观察组患儿麻醉诱导时间,苏醒时间均明显短于对照组患儿(P<0.05),两组术中麻醉持续时间相比,无统计学差异(P>0.05),均能达到期望麻醉时间,观察组患儿PAED评分和ICC评分均低于对照组患儿(P<0.05),不良反应组间比较无统计学差异(P>0.05)。结论:七氟醚联合骶管阻滞麻醉对小儿疝气手术具有良好的麻醉效果,麻醉诱导快,苏醒快,小儿配合度高,术后躁动少,值得临床推广使用。
Objective: To observe the anesthetic effects of sevoflurane and caudal block anesthesia on pediatric hernia surgery. Methods: Eighty children with inguinal hernia were selected and randomly divided into two groups according to the random number table. The control group (n = 39) received ketamine intravenously. The observation group (n = 41) received 8% sevoflurane and then sacral canal Block anesthesia, observe and record the vital signs, anesthesia induction time, recovery time, anesthesia time, Pediatric anesthesia emergence delirium (PAED) and Induction Compliance Checklist ICC) and adverse reactions during anesthesia were evaluated. The anesthetic effect of sevoflurane combined with caudal block anesthesia on pediatric hernia was evaluated. Results: The heart rate (HR) and mean arterial pressure (MAP) at T1 and T2 of both groups were significantly higher than those at T0 (P <0.05) No significant difference (P> 0.05). At T3, the HR and MAP levels in both groups recovered to the level at T0. There was no significant difference (P> 0.05) between the two groups before and after the cutaneous oxygen saturation (Sp O2) at 4 time points. The anesthesia induction time and recovery time in the observation group were significantly shorter than those in the control group (P <0.05). There was no significant difference between the two groups in the duration of anesthesia (P> 0.05), and the expected anesthesia time , PAED score and ICC score in the observation group were lower than those in the control group (P <0.05). There was no significant difference between the adverse reaction groups (P> 0.05). Conclusion: Sevoflurane combined with caudal block anesthesia has a good anesthetic effect on children ’s hernia surgery. It has the advantages of rapid induction of anesthesia, fast recovery, high degree of coordination in children and few postoperative agitation. It is worth to be used clinically.