CAJ | 학술논문

目的探讨头皮神经阻滞复合七氟醚在儿童钻孔引流手术中的应用。方法选择行钻孔引流术的患儿40例，分为头皮神经阻滞复合七氟醚组（A组）和七氟醚静吸复合麻醉组（B组）各20例。观察并记录麻醉诱导前、诱导后5 min、切皮时、手术开始15 min、手术结束时、术后30、120 min的平均动脉压（MAP）、心率（HR）变化，并对清醒时间、术后恶心呕吐发生率、术后烦躁发生率及芬太尼用量进行比较。结果 B组切皮时、手术开始15 min、手术结束时、术后30、120 min ，HR、MAP较术前明显升高（ P＜0．05），A组比B组清醒时间明显缩短（ P＜0．05），芬太尼用量明显减少，差异均有统计学意义（P＜0．05）。B组术后出现哭闹16例，躁动14例发生率明显高于A组，差异有统计学意义（ P＜0．05）。结论七氟醚复合头皮神经阻滞用于小儿钻孔引流术的方法相对于单纯七氟醚静吸复合麻醉诱导、苏醒快，生命体征稳定，不良反应少，芬太尼用量少，用于小儿钻孔引流术具有很好的麻醉与术后镇痛效果、安全可行、简单有效。
목적탐토두피신경조체복합칠불미재인동찬공인류수술중적응용。방법선택행찬공인류술적환인40례，분위두피신경조체복합칠불미조（A조）화칠불미정흡복합마취조（B조）각20례。관찰병기록마취유도전、유도후5 min、절피시、수술개시15 min、수술결속시、술후30、120 min적평균동맥압（MAP）、심솔（HR）변화，병대청성시간、술후악심구토발생솔、술후번조발생솔급분태니용량진행비교。결과 B조절피시、수술개시15 min、수술결속시、술후30、120 min ，HR、MAP교술전명현승고（ P＜0．05），A조비B조청성시간명현축단（ P＜0．05），분태니용량명현감소，차이균유통계학의의（P＜0．05）。B조술후출현곡료16례，조동14례발생솔명현고우A조，차이유통계학의의（ P＜0．05）。결론칠불미복합두피신경조체용우소인찬공인류술적방법상대우단순칠불미정흡복합마취유도、소성쾌，생명체정은정，불량반응소，분태니용량소，용우소인찬공인류술구유흔호적마취여술후진통효과、안전가행、간단유효。
Objective To study the application of nerve block scalp combined with sevoflurane in children drilling drainage oper-ation .Methods 40 children cases undergoing drilling drainage were selected and randomly divided into the scalp nerve block com-bined sevoflurane group(A ,n=20) and the sevoflurane intravenous inhalational combined anesthesia (B ,n= 20) .The changes of HR and MAP before before induction and at 5 min after induction ,skin incision ,15 min after operation beginning ,operation end , postoperative 30 ,120 min were observed and recorded .The awaking time ,occurrence rate of postoperative nausea and vomiting ,in-cidence rate of postoperative dysphoria and fentanyl dosage were compared between the two groups .Results HR ,MAP at skin in-cision ,15 min after operation beginning ,operation end ,postoperative 30 ,120 min in the group B were significantly increased than before operation(P<0 .05);the awaking time in the group A was significantly shortened compared with the group B (P<0 .05) , the fentanyl dosage was significantly reduced (P<0 .05);in the group B ,crying and screaming appeared in 16 cases ,dysphoria oc-curred in 14 cases ,the incidence rate was significantly higher than that in the group A (P<0 .05) .Conclusion Compared with sim-ple sevoflurane intravenous inhalational combined anesthesia ,sevoflurane combined with scalp nerve block used in children drilling drainage operation has rapid induction and rapid awaking ,stable vital signs ,fewer adverse reactions ,small fentanyl dosage and bet-ter anesthetic and postoperative analgesic effects ,which is safe ,feasible ,simple and effective .