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目的:评价左旋布比卡因和罗哌卡因行单次骶管阻滞麻醉用于小儿下腹部、会阴区手术的效果。方法:择期行腹股沟斜疝、隐睾睾丸固定术等脐以下手术患儿90例,ASA分级Ⅰ或Ⅱ级,以贯序法将以上70例分为2组(n=45),即在骶管阻滞中,A组给予0.25%罗哌卡因,B组给予0.25%左旋布比卡因;采用婴幼儿镇痛评分(CHIPPS)评估患儿恢复期镇痛情况,观察并记录2组手术时间、麻醉起效时间、镇痛维持时间、生命体征及术后相关并发症发生情况。结果:与A组比较,B组患儿麻醉起效时间加快,镇痛维持时间延长,术后1h、3h的CHIPPS评分提高,组间比较差异均有统计学意义(P<0.05);2组手术时间及围术期恶心呕吐、低血压等并发症发生情况相似,组间差异无统计学差异(P>0.05)。结论:0.25%罗哌卡因与0.25%左旋布比卡因骶管阻滞用于小儿下腹部、会阴区等泌尿外科手术,同样安全确切,与罗哌卡因比较,左旋布比卡因用于小儿骶管麻醉,麻醉起效时间加快,镇痛效果延长,不失为更为理想的小儿骶管麻醉用药。
OBJECTIVE: To evaluate the efficacy of levobupivacaine and ropivacaine for single sacral block anesthesia for pediatric lower abdomen and perineal surgery. Methods: Ninety children undergoing umbilicus operation undergoing incision with inguinal hernia and cryptorchidism testis were randomly divided into two groups (n = 45) In group B, 0.25% levobupivacaine was given in group A and 0.25% levobupivacaine in group B. Childbirth analgesia score (CHIPPS) was used to evaluate the pain relief during convalescence. Time, anesthesia onset time, analgesic maintenance time, vital signs and postoperative complications related to the situation. Results: Compared with group A, the onset time of anesthesia and the duration of analgesia were prolonged in children in group B, and the CHIPPS scores at 1h and 3h after operation were significantly increased (P <0.05). Group 2 The operative time, perioperative nausea and vomiting, hypotension and other complications were similar, with no significant difference between the two groups (P> 0.05). Conclusions: Caudal caudal anesthesia with 0.25% ropivacaine and 0.25% levobupivacaine is equally safe and effective for urinary surgery in the lower abdomen and perineal region of children. Compared with ropivacaine, levobupivacaine In children with caudal anesthesia, anesthesia onset of onset, analgesic effect is prolonged, after all, a more ideal pediatric caudal anesthesia medication.