CAJ | 학술논문

目的：比较骶管阻滞麻醉和全凭吸入七氟醚麻醉在婴儿肛周脓肿手术中的应用效果。方法选取行肛周脓肿手术的婴儿49例，随机分为骶管阻滞组（ C组）24例，全凭吸入七氟醚组（ S组）25例。 C组采用0．5％～0．8％利多卡因复合0．15％罗哌卡因（0．5 mL／kg）行骶管阻滞，S组吸入3％～4％七氟醚行全身麻醉。记录两组患儿麻醉诱导前（T0）、麻醉诱导后（T1）、手术开始时（T2）和手术结束后（T3）各时点的心率（HR）、血压（BP）、呼吸（R）和脉搏血氧饱和度（ SpO 2）等。记录两组患儿麻醉起效时间、喉痉挛发生率及麻醉苏醒期躁动评分。结果两组患儿麻醉起效时间、T0和T1时点的HR、BP、R和SpO2未见明显差异（ P＞0．05）。与C组相比，S组患儿T2和T3时间点的HR、R，喉痉挛发生率、麻醉苏醒期躁动评分明显升高（ P＜0．05）。结论与全凭吸入七氟醚麻醉相比，骶管阻滞对患儿生理干扰更小、镇痛更完善、麻醉苏醒期更安静。因此骶管阻滞更适合用于婴儿肛周脓肿手术的麻醉。
목적：비교저관조체마취화전빙흡입칠불미마취재영인항주농종수술중적응용효과。방법선취행항주농종수술적영인49례，수궤분위저관조체조（ C조）24례，전빙흡입칠불미조（ S조）25례。 C조채용0．5％～0．8％리다잡인복합0．15％라고잡인（0．5 mL／kg）행저관조체，S조흡입3％～4％칠불미행전신마취。기록량조환인마취유도전（T0）、마취유도후（T1）、수술개시시（T2）화수술결속후（T3）각시점적심솔（HR）、혈압（BP）、호흡（R）화맥박혈양포화도（ SpO 2）등。기록량조환인마취기효시간、후경련발생솔급마취소성기조동평분。결과량조환인마취기효시간、T0화T1시점적HR、BP、R화SpO2미견명현차이（ P＞0．05）。여C조상비，S조환인T2화T3시간점적HR、R，후경련발생솔、마취소성기조동평분명현승고（ P＜0．05）。결론여전빙흡입칠불미마취상비，저관조체대환인생리간우경소、진통경완선、마취소성기경안정。인차저관조체경괄합용우영인항주농종수술적마취。
Objective To compare the effects of caudaI bIock and totaI inhaIation anesthesia by sevofIurane on perianaI abscess surgery in infants.Methods A totaI of 50 infants scheduIed to undergo perianaI abscess surgery were randomIy divided into two groups with twenty five in each.Infants in caudaI bIock group (C group) were conducted caudaI bIock using Iidocaine 0.5%~0.8%compound ropivacaine 0.15%,the totaI voIume of Iidocaine and ropivacaine was 0.5 mL/kg.Infants in totaI inhaIation anesthesia group ( S group) were conducted generaI anesthesia by sevofIurane 3%~4%.VitaI signs such as eIectrocardiography, non-invasive bIood pressure, re-spiratory rate and puIse oxygen saturation were recorded at the time of before anesthesia in-duction (T0),after anesthesia induction ( T1),at the beginning of operation ( T2) and at the end of operation ( T3 ) .The anesthesia onset time, the incidence of Iaryngospasm and emer-gence agitation score were recorded.Results There were no significant differences in anesthesia onset time,heart rate, non-invasive bIood pressure, breathing and puIse oxygen saturation at the time point T0 and T1 between the two groups (P>0.05).Compared with those in S group, heart rate and breathing were more stabIe at the time point T2 and T3,and the incidence of Ia-ryngospasm were aIso significantIy reduced in C group ( P<0.05) .Moreover,the emergence agi-tation score in C group was Iower as compared with S group ( P<0.05 ) .Conclusion Compared with totaI inhaIation anesthesia by sevofIurane, caudaI bIock generates Iess physioIogicaI dis-turbances,provides better anaIgesia and infants with caudaI bIock are more equiIibrium in anes-thesia recovery period.Therefore,caudaI bIock is more suitabIe for abscess surgery in infants.