微创医学

目的探讨骶麻复合插管全麻在行腹腔镜婴幼儿先天性巨结肠根治术中的应用。方法选择40例行腹腔镜先天性巨结肠根治术患儿,随机分成观察组和对照组(n=20)。观察组采用骶麻复合插管全麻,对照组采用插管全麻。记录全部病例术前(T1),CO2气腹后5min(T2)、10min(T3),CO2气腹放气后5min(T4),经肛门操作后5min(T5)的心率(HR)、收缩压(SBP)、舒张压(DBP)、气道峰压(PIP);每个病例的芬太尼、维库溴铵、异丙酚的平均用量;拔管时间平均值。结果两组患儿与术前T1比较T2、T3、T4、T5时点的HR、SBP、DBP、PIP显著升高。与对照组比较,观察组术中HR、SBP、DBP、PIP波动较小,芬太尼、异丙酚、维库溴铵的用量明显小于对照组,术毕至苏醒拔管时间的平均值亦小于对照组。结论骶麻复合插管全麻可用于腹腔镜婴幼儿先天性巨结肠根治术。

Objective To study the feasibility of sacral anaesthesia combined with general anaesthesia intubation in laparoscopic radical macrosigmoid operation of infant congenital megacolon disease.Methods Forty infants undergoing laparoscopic radical macrosigmoid operation for congenital megacolon disease were randomly divided into tow groups:the observation group,performed with sacral anaesthesia combined with general anaesthesia intubation,and the control group,performed with anaesthesia intubation.HR,SBP,DBP,PIP of all patients were recorded before operation (T1),5 min(T2) and 10 min (T3) after pneumoperitoneum with CO2 (PPC),and 5 min after PPC ending (T4),5min after anal operation(T5).The average consumption of fentanyl,propofol,vecuroniun and the average extubation time were also recoded.Results HR,SBP,DBP,and PIP of both groups at the point of T2,T3,T4,and T5 were significantly higher than those before operation(T1).Compared with the control group,HR,SBP,DBP,and PIP fluctuated more slightly,with less fentanyl propofol dosage and analepsia time after operation in the observation group.Conclusion Sacral anaesthesia combined with general anaesthesia intubation can be applied for laparoscopic radical macrosigmoid operation of infant congenital megacolon disease

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