摘要
目的:比较不同剂量羟考酮联合腹横肌平面阻滞在小儿腹腔镜疝囊高位结扎术中的应用效果。方法:选择2020年1-12月于德阳市人民医院行单侧腹腔镜疝囊高位结扎术的90例患儿为研究对象,采用随机数字表法分为A组、B组、C组,每组30例。三组均依次静脉给予阿托品0.02 mg/kg、舒芬太尼0.3μg/kg、丙泊酚2.5 mg/kg、顺阿曲库铵0.15 mg/kg后,A组给予羟考酮0.05 mg/kg,B组给予羟考酮0.1 mg/kg,C组给予同A组等量的0.9%氯化钠溶液。气管插管后,3组均以3%七氟烷维持麻醉,氧流量2 L/min,麻醉诱导完成后行超声引导下患侧腹横肌平面阻滞(0.33%罗哌卡因,1.5 mg/kg),分别记录3组患儿麻醉诱导前(T0)、插管即刻(T_(1))、建立人工气腹后(T_(2))、疝囊结扎时(T_(3))、手术结束(T_(4))、苏醒即刻(T_(5))的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP),记录T_(5)、离开复苏室即刻(T_(6))、术后4 h(T_(7))和术后8 h(T8)患儿的FLACC行为评分及Ramsay评分,记录苏醒时间、复苏室停留时间,观察患儿术后恶心、呕吐、术后躁动、呼吸抑制等不良反应发生率。结果:A组HR在T_(1)、T_(2)、T_(3)、T_(5)均低于C组(P<0.05),而B组HR、MAP在T_(1)、T_(2)、T_(3)、T_(4)、T_(5)均低于C组(P<0.05)。A组、B组患儿FLACC评分在T_(5)、T_(6)、T_(7)均低于C组,差异均有统计学意义(P<0.05);A组、B组Ramsay评分在T_(5)、T_(6)、T_(7)均高于C组,差异均有统计学意义(P<0.05);B组在T_(5)、T_(6)的FLACC评分均低于A组,差异均有统计学意义(P<0.05)。与C组比较,A组、B组苏醒时间均稍延长,差异均无统计学意义(P>0.05);与C组比较,B组术后躁动发生率降低(P<0.05),而A组术后躁动发生率稍降低,差异无统计学意义(P>0.05);三组的复苏室停留时间和其他不良反应比较,差异均无统计学意义(P>0.05)。结论:0.5 mg/kg及0.1 mg/kg剂量的羟考酮可以安全的用于小儿腹腔镜疝囊高位结扎术,可减轻术后疼痛,�
Objective:To compare the effects of different doses of Oxycodone combined with transversus abdominis plane block in the high ligation of laparoscopic hernia sac in children.Method:A total of 90 children who underwent unilateral laparoscopic high ligation of hernia sac in Deyang People's Hospital from January to December 2020 were selected as the research objects and divided into group A,group B and group C by random number table method,with 30 cases in each group.The three groups were given Atropine 0.02 mg/kg,Sufentanil 0.3μg/kg,Propofol 2.5 mg/kg and Cisatracurium 0.15 mg/kg intravenously,group A was given Oxycodone 0.05 mg/kg,group B was given Oxycodone 0.1 mg/kg,and group C was given 0.9%Sodium Chloride Solution of the same amount as group A.After endotracheal intubation,anesthesia was maintained with 3%Sevoflurane and oxygen flow rate was 2 L/min.After anesthesia induction,ultrasound-guided transversal plane block was performed on the affected side(0.33%Ropivacaine,1.5 mg/kg).The heart rate(HR)and mean arterial pressure(MAP)of the three groups were recorded before anesthesia induction(T0),immediately after intubation(T_(1)),after the establishment of artificial pneumoperitoneum(T_(2)),at the time of hernia sac ligation(T_(3)),after surgery(T_(4))and immediately after recovery(T_(5)),FLACC behavior score and Ramsay score of T_(5),immediately after leaving resuscitation room(T_(6)),4 h after surgery(T_(7))and 8 h after surgery(T8)were recorded.The recovery time and stay time in resuscitation room were recorded,and the incidence of postoperative nausea,vomiting,postoperative agitation,respiratory depression and other adverse reactions were observed.Result:The intraoperative HR at T_(1),T_(2),T_(3),T_(5)of group A were lower than those of group C(P<0.05),while the intraoperative HR and MAP at T_(1),T_(2),T_(3),T_(4),T_(5)of group B were lower than those of group C(P<0.05).The FLACC scores at T_(5),T_(6)and T_(7)of group A and group B were lower than those in group C,the differences were statistically significan
作者
熊超
翟文虎
张先杰
XIONG Chao;ZHAI Wenhu;ZHANG Xianjie(Deyang People's Hospital,Sichuan Province,Deyang 618000,China)
出处
《中国医学创新》
CAS
2023年第13期13-18,共6页
Medical Innovation of China
关键词
羟考酮
腹横肌平面阻滞
小儿
疝囊高位结扎术
Oxycodone
Transversus abdominis plane block
Children
High ligation of hernia sac
