33例连续骶管阻滞麻醉在小儿长时间手术中研究.docVIP

33例连续骶管阻滞麻醉在小儿长时间手术中研究【中图分类号】R726.1【文献标识码】A【文章编号】1672-6383-（2010）12-0004-02 【摘要】目的：分析连续骶管阻滞麻醉在小儿较长时间手术中的临床效果。 方法：术前30min肌注阿托品，在氯胺酮基础麻醉下，左侧卧位辨明骶裂孔，用左手拇指固定，使用18G管内针与皮肤约45°角向头端进针，穿过骶尾韧带有突破感后再送入套管。回抽无血、无液，先注试验剂量，观察无异常后再注全量。根据不同年龄采用0.8%～1.5%利多卡因，每隔60min追加局麻药，药量为首次剂量的1/2。术中常规监测ECG、HR、RR、BP、SpO2和T。结果：本组全部顺利完成手术，麻醉效果满意。术中生命体征平稳，对循环影响小，静脉麻醉种类和用量明显减少。无麻醉意外及骶管穿刺后并发症。结论：采用连续骶管阻滞技术可根据手术需要，延长麻醉时间，减少静脉药量，满足手术需要，且操作简便，生理干扰小。 【关键词】连续骶管阻滞；小儿 Continuous Sacral Tube Block Anesthesia in Pediatric Long Operation of this Analysis ：A Report of 33 cases Lai Gui Yong， Li Ju Xi， Luo Zheng Tong，et al 【Abstract】Objective： Analysis of continuous sacral tube block anesthesia in pediatric surgery for a long time the clinical effect.Methods：Preoperative 30min muscle note atropine， based in ketamine anesthesia， left lie a discern sacral hole， with left thumb is fixed， the needle tube use 18G skin about 45 ° Angle to the head， through the needle into the sacral tail ligament in breakthrough feeling again after into casing. Back to smoke no blood， no liquid， first note test doses， observe no abnormal again after the note， total content. According to different age by 0.8% - 1.5% lidocaine， every 60min additional local anesthetics， for the first time， drug doses of 1/2. Intraoperative routine monitoring ECG， HR， RR， BP， SpO2 and T.Results： Group all successfully completed surgery， anesthesia with satisfactory effect. Intraoperative vital signs smooth of circular effect is small， intravenous anesthesia type and dosage were obviously reduced. Without anesthesia accidents and di tube puncture complications after.Conclusion：The continuously sacral tube block technology can according to need surgery， prolong anesthesia time， reduce vein dosage， satisfy the operation needs， easy operation， physiological little interference. 【Keywords】Continuous sacral tube block， Children 骶管阻滞是小儿手术常用的安全有效的麻醉方法之一，为硬外腔阻滞的一种。采用连续骶管阻滞麻醉可以根据手术需要，不受时间限制，任意延长麻醉时间，减少静脉用药量。我院自2006年3月至2010年8月以来对33例较长时间手术的小儿采用连续骶管阻滞，取得