摘要
目的探讨超声引导下改良TAP阻滞在小儿日间手术中的应用效果。方法选取我院2016年7月~2017年1月小儿腹股沟区域日间手术(包括腹股沟斜疝和鞘膜积液)90例为研究对象,随机分为对照1组、对照2组和观察组各30例。对照1组以0.25%罗哌卡因1m L/kg行骶管神经阻滞,对照2组以0.25%罗哌卡因0.75m L/kg行骶管神经阻滞,观察组在超声引导下行TAP阻滞。比较三组麻醉效果。结果对照2组需要增加吸入七氟醚浓度例数则较对照1组和观察组均多(P<0.05)。两对照组患儿下肢麻木的发生率均高于观察组(P<0.05);对照1组患儿下肢麻木的发生率高于对照2组(P<0.05)。对照2组患儿在T3心率,呼吸及平均动脉压均高于对照1组和观察组(P<0.05)。观察组患儿罗哌卡因用量少于对照1组和对照2组(P<0.05),对照2组患儿罗哌卡因用量少于对照1组(P<0.05)。观察组患儿离院时间比两对照组患儿均更早(P<0.05)。结论超声引导下髂腹股沟TAP阻滞麻醉效果确切,且可有效减少局麻药用量,因其无骶管阻滞相关并发症,术后患儿恢复快,尤其适用于小儿疝气类日间手术,值得临床推广。
Objective To discuss the application effect of modified TAP block guided by ultrasound in day operation in children.Methods From July 2016 to January 2017,90 children with inguinal area operation(including indirect inguinal hernia and hydrocele)were randomly divided into control group 1(n=30),control group 2(n=30)and observation group(n=30).Control group 1 were received sacral nerve block with 0.25%ropivacaine 1ml/kg and control group 2 with 0.25%ropivacaine 0.75ml/kg.The observation group were received TAP block under ultrasound guidance.The anesthetic effect of the three groups were compared.Results The number of patients in control group 2 who needed to increase sevoflurane concentration was more than that in control group and observation group(P<0.05).The incidence of lower limb numbness in the two control groups was higher than that in the observation group(P<0.05),and the incidence of lower limb numbness in the control group 1 was higher than that in the control group 2(P<0.05).The heart rate,respiration and mean arterial pressure in control group 2 were higher than those in control group 1 and observation group(P<0.05).The dosage of ropivacaine in the observation group was less than that in the control group 1 and the control group 2(P<0.05),and the ropivacaine in the control group 2 was less than that in the control group 1(P<0.05).The time of the observation group was earlier than that of the control group(P<0.05).Conclusion Ultrasound-guided ilioinguinal TAP block was effective and effective in reducing the dosage of local anesthetic.Because there were no complications associated with sacral canal block,the children recovered quickly after operation,especially for children with hernia type day surgery,which is worth popularizing in clinic.
作者
刘庆仁
LIU Qingren(Department of Anesthesiology,Eighth People's Hospital of Dongguan City,Dongguan 523320,China)
出处
《中国医药科学》
2018年第6期90-92,151,共4页
China Medicine And Pharmacy
基金
广东省东莞市医疗卫生科技计划一般项目(2016105101125)
关键词
超声引导
改良TAP阻滞
小儿
日间手术
Ultrasound guidance
Improved TAP block
Children
Daytime operation
