硬膜外阻滞辅以全麻在小儿手术治疗中的应用

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1、硬膜外阻滞辅以全麻在小儿手术治疗中的应用硬膜外阻滞辅以全麻在小儿手术治疗中的应用【中图分类号】R614.2【文献标识码】A【文章编号】1672-6383-(2010)12-0067-02【摘要】目的：本文对我院自2007年8月至2010年8月在硬膜外阻滞辅以全麻用于小儿手术的临床效果进行总结。方法：30例手术患儿随机分为单纯全麻I组和硬膜外辅以全麻I【组，每组15例。观察两组病人循环功能的改变、术中全麻药的用量、手术部位肌松程度及术毕清醒时间。结果：两组病人一般情况、手术时间无明显差异(P>0.05)o血压、心率于术前、术中、术毕清醒时有明显差异(PV0.05)o苏醒时间组间相比有明显差异

2、性(PV0.01),术中麻醉用药两组间有明显差异(PV0.01),手术部位肌松程度有明显差异。结论：硬膜外阻滞辅以全麻用丁•小儿手术患儿循环系统更平稳、全麻用药量小，患儿苏醒快，肌松程度更满意。【关键词】硬膜外阻滞；全麻；小儿Outsidethehardmembranehindersauxiliarybythegeneralanesthesia,intheyoungchildsurgerytreatstheapplicationWeiQimei[Abstract]Objective：Thisarticle-2010yearinAugusthinderstomycourtyardfromAu

3、gust,2007outsidethehardmembraneauxiliarytouseintheyoungchildsurgery'sclinicaleffectbythegeneralanesthesiacarryingonthesummary.Method：30examplesurgerybabydividesintothepuregeneralanesthesiaIgroupstochasticallywiththehardmembraneoutsideauxiliarybythegeneralanesthesiaIIGroup,eachgroupof15examples・Obs

4、ervestwogroupofpatientloopfunctioninthechange,thetechniquetheentireanestheticamountused,thesurgeryspotmyo-loosedegreeandthetechniquefinishesthesobertime・Finally：Twogroupofpatientordinarycircumstances,surgerytimenotobviousdifference(P>0.05).Thebloodpressure,theheartrateinthetechnique,thetechnique,t

5、hetechniquefinishissoberwhenhavetheobviousdifference(P<0.05)oTheregainingconsciousnesstimegroupcompareshastheobviousdifference(P<0.01),Inthetechniqueanaesthetizesappliesdrugsduringtwogroupstohavetheobviousdifference(P<0.01),Thesurgeryspotmyo-loosedegreehastheobviousdifference・Conclusion：Outsidethe

6、hardmembranehindersauxiliarytouseintheyoungchildsurgerybabycirculatorysystembythegeneralanesthesiabeingsteadier,thegeneralanesthesiatobesmallwiththedose,thebabyregainsconsciousnessquickly,themyo-loosedegreeismoresatisfied・[Keywords]Outsidethehardmembranehinders；Generalanesthesia；Youngchild1临床资料1・

7、1病例：全组30例，男18例、女12例，年龄3〜12岁,体重11.5〜30kg,ASA为I〜II级。腹腔镜下阑尾切除术10例，鞘膜积液翻转术6例，经腹斜疝高位结扎术6例，下肢手术4例，开腹阑尾切除术2例，腹腔镜下斜疝高位结扎术2例。1.2麻醉方法：患儿入手术室后缓慢静脉注射氯胺酮1〜2mg/kg或肌肉注射氯胺酮5~7mg/kg，待神志消失后，II组将患儿置于左侧卧位选用肓入法行硬膜外腔穿刺，穿刺部位L1〜L2间隙，穿刺成