山东医药2017，Vol.57Issue(4)：9-12,4.DOI:10.3969/j.issn.1002-266X.2017.04.001
超声引导下 IINB 复合全麻用于儿童腹股沟疝日间手术效果观察
Efficacy of ultrasound-guided IINB combined with general anesthesia for inguinal hernia repair in pediatric ambulatory surgery
摘要
Abstract
Objective To investigate the clinical effects and validity of ultrasound-guided ilioinguinal/iliohypogastric nerve block ( IINB) combined with general anesthesia for inguinal hernia repair in pediatric ambulatory surgery .Methods Forty cases of 1 to 5-year-old inguinal hernia pediatric patients were randomly divided into the IINB group and ultra -sound-guided IINB group , and 20 cases in each group .Children from both groups were performed IINB under propofol gen-eral anesthesia , children in the IINB group with Schulte-Steinbery method , and children in the ultrasound-guided IINB group under the guidance of ultrasound .At the time of incision and ligation of hernia sac , the children′s body motion was observed, and the number of patients who were treated with additional bolus propofol was recorded .HR and mean arterial pressure ( MAP) were recorded before , at the end of the induction , at the end of the incision , immediately after the ligation of the hernia sac , and at the end of the surgery and recovery .The retention time in postanesthesia care unit ( PACU) was recorded .The number of cases of children with vomiting , puncture site hemorrhage or hematoma , local anesthetics into the blood or delayed awakening was recorded during the PACU period .The Eastern Ontario Children′s Hospital Pain Scale ( CHEOPS score ) was performed at the time of PACU .Results Body movement occurred in 12 cases during skin inci-sion, and 14 cases were treated with propofol in the IINB group , which were 5 and 6 cases respectively in the ultrasound-guided IINB group, and significant difference was found between them (P<0.05).At the skin incision, immediately after the ligation of the hernia sac , and at the end of the surgery and recovery , the HR was lower in the ultrasound-guided IINB group than that in the IINB group (P<0.05 or P<0.01).There were 2 cases of children with vomiting in PACU in both groups.There was no hemorrhage or hematoma of puncture site , local anesthetic toxicity and delayed awakening in all pa-tients.No difference was found in the length of stay in PACU between the two groups (P>0.05).The CHEOPS score of children when they left the PACU was (7.05 ±1.47) points in the the IINB group and (5.30 ±0.92) points in ultra-sound-guided IINB group , and significant difference was found between them ( P <0.01 ) .Conclusions Ultrasound-guided IINB combined general anesthesia can improve the effect of iliohypogastric and ilioinguinal nerve block in ambulatory inguinal hernia pediatric surgery .The vital signs are stable and the acute pain is relieved after operation .关键词
腹股沟疝/超声/神经阻滞/日间手术/小儿Key words
inguinal hernia/ultrasonography/nerve block/ambulatory surgery/child分类
医药卫生引用本文复制引用
方欣,郑超,刘国亮,张建敏..超声引导下 IINB 复合全麻用于儿童腹股沟疝日间手术效果观察[J].山东医药,2017,57(4):9-12,4.基金项目
首都临床特色应用研究与成果推广（Z161100000516142）。 （）
