阴茎背神经阻滞在小儿尿道下裂手术麻醉中的应用

摘要

目的：探讨阴茎背神经阻滞在小儿尿道下裂手术麻醉中的应用。方法90例行尿道下裂手术的男性患儿，采用简单随机法分为A、B、C三组各30例。均常规麻醉诱导插管，插管后A组行阴茎根部阻滞，B组行骶管阻滞，C组患儿给予芬太尼静滴。比较三组拔管时间、拔管后哭闹例数、复苏室处置时间及复苏室追加镇痛药物的次数。结果 A、B两组患儿拔管时间、拔管后哭闹的比率、复苏室停留时间及复苏室使用镇痛药物的比率均低于C组，差异均有统计学意义（ P＜0.05）。结论阴茎背神经阻滞与骶管阻滞在小儿尿道下裂手术中可以减少全麻药物的使用，缩短复苏时间，具有良好的术后镇痛作用，但阴茎背神经阻滞操作简单，更适合临床应用。%Objective To investigate the feasibility of dorsal penile nerve block in children undergoing hypospadias surgery . Methods Ninety children with hypospadias were divided into 3 groups:dorsal penile nerve block group (group A),sacral canal bloc-king group (group B)and control group (group C).After tracheal intubation,the group A was given 0.5%ropivacaine plus 1% lido-caine for dorsal penile nerve block;the group B was given 0.125%ropivacaine 1 mg/Kg for sacral canal blocking while 2μg/Kg fenta-nyl was given in the group C before surgery beginning .The extubation time,staying time in PACU and supplementary dose of opioid drugs were recorded .Results The extubation time in the group A and B was significantly shorter than that in the group C ( P <0.05 ) .The ratio of dysphoria in the group C was significantly higher than that in the group A and B ( P <0.05 ) .The ratio of using opioid drugs in PACU in the group C was significantly higher than that in the group A and B ( P<0.05 ) .Conclusion The dorsal pe-nile nerve block and sacral canal block can decrease the use of general anesthetics ,shorter the recovery time and provide better postop-erative analgesia .