父母陪护下喉罩吸入七氟醚联合骶麻在小儿尿道下裂成形术中的应用

摘要

目的 探讨父母陪护下喉罩吸入七氟醚联合骶麻的方式在小儿尿道下裂成形术中的应用.方法 将患几分为A、B组各40例,A组采用父母陪护下喉罩吸入七氟醚联合骶麻,B组则采用氯胺酮麻醉联合骶麻,统计两组患儿术中平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度、苏醒时间、出室时间、术中体动反应、呛咳屏气、术后躁动、恶心与呕吐,患儿家属和医护人员的满意度.结果 A组各个时间点的MAP和HR比B组平稳(P＜0.05).A组的苏醒时间、出室时间明显比B组短[(11.5±2.3) min vs.(17.6±6.4) min,(17.9-± 1.9) min vs.(33.1±3.2)min](t=4.236,6.339;P＜0.05).A组术中体动反应和呛咳屏气的发生率也明显比B组低(5.0％vs.30.0％,2.5％ vs.27.5％)(x2=15.632,22.354;P＜0.05).A组患儿家属满意度比B组高(100.0％vs.85.0％; x2=3.014,P＜0.05).结论 父母陪护下喉罩吸入七氟醚联合骶麻的方式可以使血流动力学指标更加平稳,苏醒时间和出室时间更短,麻醉不良反应更少,患儿家属满意度更高.%Objective To investigate the application of laryngeal mask inhalation sevoflurane anesthesia combined with sacral block accompanied by parents in children urethroplasty of hypospadias.Methods Children were divided into group A and group B,40 cases in each group.Group A was treated with laryngeal mask inhalation sevoflurane anesthesia combined with sacral block accompanied by parents,while group B was treated with ketamine anesthesia combined with sacral block.The mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation,the time of palinesthesia,the time out of operating room,body movement during surgery,bucking and breath holding,postoperative agitation,nausea and vomiting,and the degree of satisfaction of family member and medical personnel of two groups were recorded.Results Compared with group B,MAP and HR in group A were stabler (P＜0.05).The time of palinesthesia and time out of operating room in group A were shorter than those in group B [(11.5 ± 2.3)min vs.(17.6 ± 6.4)min,(17.9±1.9)min vs.(33.1 ± 3.2)min] (t=4.236,6.339; P＜0.05).The incidences of body movement during surgery and bucking and breath holding in group A were much lower than those in group B (5.0％ vs.30.0％,2.5％ vs.27.5％) (x 2=15.632,22.354; P＜0.05).The degree of satisfaction of family member in group A was higher than that in group B (100.0％ vs.85.0％; x 2=3.014,P＜0.05).Conclusion Laryngeal mask inhalation sevoflurane anesthesia combined with sacral block accompanied by parents can lead to stabler hemodynamics indexes,shorter time of palinesthesia and time out of operating room,fewer adverse reactions of anesthesia,higher degree of satisfaction of family member.