CAJ | 학술논문

目的：比较喉罩吸入七氟醚联合不同阻滞麻醉方法在小儿腹股沟区手术的应用效果。方法选择择期行腹股沟区手术患儿90例，年龄1~4岁，随机分为喉罩吸入七氟醚联合髂腹股沟-髂腹下神经阻滞组(Ⅰ组）、喉罩吸入七氟醚联合骶麻组(Ⅱ组)、喉罩吸入七氟醚复合芬太尼组(Ⅲ组)，每组30例。术中保留自主呼吸。观察比较麻醉诱导前(T0)、切皮后3 min (T1)、开始缝皮时(T2)和手术结束时(T3)的心率和血压变化，以及苏醒时间、术中体动和术后不良反应的发生率。结果Ⅲ组苏醒时间为(12.7±3.6) min，与其相比，Ⅰ组和Ⅱ组的苏醒时间明显缩短，分别为(5.2±2.3) min、(4.9±2.6) min，差异有统计学意义(P<0.05)；Ⅲ组开始缝皮时和手术结束时的心率、血压较Ⅰ组和Ⅱ组明显升高，差异有统计学意义(P<0.05)；Ⅲ组术中体动和术后不良反应的发生例数较Ⅰ组和Ⅱ组多，但差异无统计学意义(P>0.05)。结论三种麻醉方法均能良好地运用于小儿腹股沟区手术，喉罩吸入七氟醚联合髂腹股沟-髂腹下神经阻滞因其操作简便，易于掌握，苏醒及时，不良反应较少，能较好地运用于小儿腹股沟区手术。
목적：비교후조흡입칠불미연합불동조체마취방법재소인복고구구수술적응용효과。방법선택택기행복고구구수술환인90례，년령1~4세，수궤분위후조흡입칠불미연합가복고구-가복하신경조체조(Ⅰ조）、후조흡입칠불미연합저마조(Ⅱ조)、후조흡입칠불미복합분태니조(Ⅲ조)，매조30례。술중보류자주호흡。관찰비교마취유도전(T0)、절피후3 min (T1)、개시봉피시(T2)화수술결속시(T3)적심솔화혈압변화，이급소성시간、술중체동화술후불량반응적발생솔。결과Ⅲ조소성시간위(12.7±3.6) min，여기상비，Ⅰ조화Ⅱ조적소성시간명현축단，분별위(5.2±2.3) min、(4.9±2.6) min，차이유통계학의의(P<0.05)；Ⅲ조개시봉피시화수술결속시적심솔、혈압교Ⅰ조화Ⅱ조명현승고，차이유통계학의의(P<0.05)；Ⅲ조술중체동화술후불량반응적발생례수교Ⅰ조화Ⅱ조다，단차이무통계학의의(P>0.05)。결론삼충마취방법균능량호지운용우소인복고구구수술，후조흡입칠불미연합가복고구-가복하신경조체인기조작간편，역우장악，소성급시，불량반응교소，능교호지운용우소인복고구구수술。
Objective To compare effects of sevoflurane anesthesia under laryngeal mask airway combined with different nerve block methods in pediatric inguinal surgery. Methods Ninety children, aged 1~4 years old, scheduled for elective inguinal surgery, were randomly divided into three groups (n=30 each) using a random number table:group I (sevoflurane anesthesia under laryngeal mask airway combined with ilioinguinal-iliohypogastric nerve block group); group Ⅱ(sevoflurane anesthesia under laryngeal mask airway combined with caudal block group), groupⅢ(sevoflurane anesthesia under laryngeal mask airway combined with fentanyl). The heart rate and blood pres-sure were observed at four time points:before induction of anesthesia (T0), three minutes after incision (T1), the start of sewing leather (T2) and the end of surgery (T3). The recovery time, intraoperative body movement and adverse effects were recorded. Results The recovery time of groupⅢwas (12.7±3.6) min, significantly shorter than those of group Ⅰ and group Ⅱ, (5.2 ± 2.3) min, (4.9 ± 2.6) min, P<0.05. Compared with group Ⅰ and group Ⅱ, the heart rate and blood pressure were significantly higher at T2, T3 in groupⅢ(P<0.05). Compared with groupⅠand groupⅡ, the inci-dence of body movement and adverse effects were more in group III, but there was no significant difference (P>0.05). Conclusion The three anesthetic methods can be applied well in pediatric inguinal surgery. Sevoflurane anesthesia under laryngeal mask airway combined with ilioinguinal-iliohypogastric nerve block is preferred, with easy operation, quick waking up, few adverse reactions.