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目的:探讨低流量异氟烷吸入麻醉复合骶管麻醉在小儿下腹部及会阴手术中的应用。方法:选择接受手术治疗的下腹部及会阴疾病患儿80例,随机均分为对照组与实验组,手术麻醉时均采用骶管阻滞麻醉,但基础麻醉方式不同,对照组为氯胺酮静脉全身麻醉,实验组为低流量异氟烷吸入麻醉。观察并比较两组患者的睫毛反射、皮肤疼痛反射消失时间、心率、平均动脉压、意识消失时间、意识恢复时间以及麻醉苏醒期躁动发生率等指标。结果:与对照组相比,实验组睫毛反射、皮肤疼痛反射消失时间、意识恢复时间以及麻醉苏醒期躁动发生率均显著缩短以及降低(P<0.05);与麻醉诱导前相比,对照组心率及平均动脉压显著升高(P<0.05),而实验组升高不明显(P>0.05)且显著低于同期对照组水平(P<0.05)。结论:低流量异氟烷吸入麻醉复合骶管麻醉适用于小儿下腹部及会阴手术,具有诱导及恢复快、对循环影响小的特点,优于氯胺酮基础麻醉。
Objective: To investigate the application of low-flow isoflurane inhalation anesthesia combined with caudal anesthesia in pediatric lower abdomen and perineal surgery. Methods: Eighty children with lower abdomen and perineal disease who underwent surgical treatment were randomly divided into control group and experimental group. The caudal block anesthesia was used during the operation, but the basic anesthesia was different. The control group consisted of ketamine intravenous whole body Anesthesia, experimental group for low-flow isoflurane inhalation anesthesia. Eyelash reflex, skin pain reflex disappear time, heart rate, mean arterial pressure, time of consciousness disappear, consciousness recovery time and the incidence of restlessness during anesthesia recovery were observed and compared between the two groups. Results: Compared with the control group, the lashes of eyelashes, the disappearance of pain reflex, the recovery time of consciousness and the frequency of restlessness during anesthesia were significantly shortened and decreased as compared with the control group (P <0.05). Compared with that before anesthesia, heart rate And mean arterial pressure (P <0.05), while the experimental group did not increase significantly (P> 0.05) and were significantly lower than the control group at the same period (P <0.05). Conclusion: Low-flow isoflurane inhalation anesthesia combined caudal anesthesia is suitable for pediatric lower abdomen and perineal surgery, with the induction and recovery of fast, little effect on the cycle, superior to ketamine based anesthesia.