CAJ | 학술논문

目的:比较喉罩与面罩通气下氯胺酮复合骶管麻醉在小儿斜疝手术中的麻醉效果.方法:选择ASAⅠ~Ⅱ级、2~6岁择期行小儿斜疝高位结扎术40例,随机分为喉罩通气组(L组)和面罩通气组(M组),每组20例,两组患儿入室后均肌注氯胺酮5 mg/kg,2 min后行骶管阻滞,穿刺成功后1%利多卡因8~10 mg/kg骶管注射,L组患儿置入喉罩,M组患儿扣上面罩,两组患儿均保留自主呼吸,氧流量2~3 L/min.记录切皮前1 min(T1)、切皮后1 min(T2)、10 min(T3)、术毕时(T4)、清醒脱氧时(T5)的MAP、HR,记录术中SpO2<95%例数,观察两组患儿术中有无体动、误吸、术后咽痛等并发症.结果:两组患儿术中MAP、HR比较差异无统计学意义(P>0.05),L组患儿术中SpO2<95%例数明显少于M组(P<0.05),两组患儿术中均无误吸并发症(P>0.05),但L组患儿术后咽痛的发生率明显高于M组(P<0.05).结论:在小儿斜疝手术中,两种方法均安全有效,但喉罩通气下氯胺酮复合骶管麻醉能更好的维持术中呼吸道通畅,避免缺氧,保证麻醉质量,但应注意术后咽痛的防治.
목적:비교후조여면조통기하록알동복합저관마취재소인사산수술중적마취효과.방법:선택ASAⅠ~Ⅱ급、2~6세택기행소인사산고위결찰술40례,수궤분위후조통기조(L조)화면조통기조(M조),매조20례,량조환인입실후균기주록알동5 mg/kg,2 min후행저관조체,천자성공후1%리다잡인8~10 mg/kg저관주사,L조환인치입후조,M조환인구상면조,량조환인균보류자주호흡,양류량2~3 L/min.기록절피전1 min(T1)、절피후1 min(T2)、10 min(T3)、술필시(T4)、청성탈양시(T5)적MAP、HR,기록술중SpO2<95%례수,관찰량조환인술중유무체동、오흡、술후인통등병발증.결과:량조환인술중MAP、HR비교차이무통계학의의(P>0.05),L조환인술중SpO2<95%례수명현소우M조(P<0.05),량조환인술중균무오흡병발증(P>0.05),단L조환인술후인통적발생솔명현고우M조(P<0.05).결론:재소인사산수술중,량충방법균안전유효,단후조통기하록알동복합저관마취능경호적유지술중호흡도통창,피면결양,보증마취질량,단응주의술후인통적방치.
Objective:Comparison of effect of the laryngeal mask on pediatric indirect inguinal hernia operation anesthesia to mask combined with ketamine-sacral anesthesia.Methods:ASAⅠ-Ⅱ,40 patients of 2-6 years age undergoing hernia ligation,were randomly equally divided into the laryngeal mask ventilation group (L group) and mask ventilation group (M group),Two groups of children room after intramuscular injection of ketamine 5 mg/kg,after 2 min sacral block,after successful puncture 1%lidocaine 8~10 mg/kg sacral canal injection,inserting the laryngeal mask airway in L group,at the same,M group in children with buckle hood,spontaneous breathing,oxygen retention of 2~3 L/min.Record before skin incision (T1),skin incision after 1min (T2),10 min (T3),at the end of the operation (T4),sober deoxidization of (T5) MAP,HR,SpO2<95%were observed intraoperatively,beside with intraoperative have no body movement,aspiration,postoperative sore throat complications.Results:In two groups of operation on children,MAP,HR had no significant difference (P>0.05), L group in operation on children with SpO2<95%were significantly less than M group(P<0.05),two groups had no body movement,intraoperative complications such as aspiration(P>0.05 ) in L group,but postoperative sore throat had a greatly higher incidence of M group(P<0.05).Conclusion:In pediatric hernia operation, two methods are safe and effective,and in the LMA combined with ketamine-sacral anesthesia,it can be better sustaining intraoperative airway patency,avoiding of hypoxia,guaranting the quality of anesthesia,at the same shall be attention to the throat sore of postoperation.