中国合理用药探索2025，Vol.22Issue(4)：71-77,7.DOI:10.3969/j.issn.2096-3327.2025.04.011
右美托咪定硬膜外麻醉在非气管插管全身麻醉小儿腹股沟疝手术中的应用
Application of Dexmedetomidine Epidural Anesthesia in Non-Endotracheal Intubation General Anesthesia for Inguinal Hernia Surgery in Children
摘要
Abstract
Objective:To investigate the application of epidural anesthesia with dexmedetomidine combined with lidocaine and levobupivacaine in non-endotracheal intubation general anesthesia for pediatric inguinal hernia surgery.Methods:A total of 120 children who underwent pediatric inguinal hernia surgery under non-endotracheal intubation general anesthesia in a certain hospital from January 1,2021 to December 31,2023 were selected and divided into the control group and the observation group using random number table method,with 60 cases in each group.All the children were given esketamine hydrochloride injection intravenously,the control group was additionally given lidocaine hydrochloride injection and levobupivacaine hydrochloride injection for epidural anesthesia,and the observation group was additionally given dexmedetomidine hydrochloride injection in addition to the treatment for the control group.Anesthesia parameters(anesthesia induction time,postoperative awakening time,extubation time and anesthesia room stay time),hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP)]and oxygen saturation of blood(SpO2)level,oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)],inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)],Ramsay score,pediatric anesthesia emergence delirium(PAED),Children's Hospital of Eastern Ontario Pain Scale(CHEOPS)and adverse reactions were compared between the two groups.Results:The anesthesia induction time,postoperative awakening time,extubation time and anesthesia room stay time in the observation group were shorter than those in the control group(P<0.05).The levels of HR and MAP during the surgery and 10 min post-surgery in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in SpO2 level between the two groups during the surgery and 10 min post-surgery(P>0.05).One day after operation,the level of SOD was decreased in both groups(P<0.05),but higher in the observation group than that in the control group(P<0.05).The levels of MDA,TNF-α,CRP,IL-6 and IL-1β were increased in both groups(P<0.05),but lower in the observation group than in the control group(P<0.05).The Ramsay score at different time points in the observation group were higher than those in the control group(P<0.05).The PAED scores at 30 min and 1 h after operation in the observation group were lower than those in the control group(P<0.05).The CHEOPS scores at 12 h and 24 h after operation in the observation group were lower than those in the control group(P<0.05).No statistically significant difference was observed in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dexmedetomidine combined with lidocaine and levobupivacaine for epidural anesthesia in non-endotracheal intubation general anesthesia for pediatric inguinal hernia surgery demonstrated good anesthetic effect,with minor fluctuations in hemodynamic parameters,oxidative stress and inflammatory levels,and favorable safety.关键词
右美托咪定/利多卡因/左布比卡因/硬膜外麻醉/非气管插管/全身麻醉/小儿腹股沟疝手术Key words
dexmedetomidine/lidocaine/levobupivacaine/epidural anesthesia/non-endotracheal intubation/general anesthesia/pediatric inguinal hernia surgery分类
医药卫生引用本文复制引用
张华磊,石鑫磊,孙铭泽..右美托咪定硬膜外麻醉在非气管插管全身麻醉小儿腹股沟疝手术中的应用[J].中国合理用药探索,2025,22(4):71-77,7.基金项目
河南省医学科技攻关计划项目(LHGJ20211029) （LHGJ20211029）
