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目的:探讨七氟烷吸入复合骶管阻滞在腹腔镜下小儿腹股沟斜疝疝囊高位结扎术的麻醉效果、安全性及可行性。方法:选择1~4岁ASAⅠ~Ⅱ级的腹股沟斜疝患儿83例在腹腔镜下行疝囊高位结扎术。采用8%七氟烷复合氧气(2~3L/min)面罩吸入,待睫毛反射消失、疼痛反射消失后行骶管阻滞,经鼻孔放置气体采样管监测呼气末二氧化碳(PETCO2),术中以微量泵持续泵注丙泊酚,间断吸入七氟烷。观察麻醉效果、气腹前、气腹后及放气腹后的SPO2、PETCO2、HR、R等的变化。结果:镇痛完全76例,欠缺7例,患者术中肌松能满足手术要求。气腹后PETCO2显著增加,P<0.01,自主呼吸尚能代偿,SPO2稳定。结论:骶管阻滞用于腹腔镜下小儿腹股沟斜疝疝囊高位结扎术麻醉效果确切、安全,可满足手术的需要。
Objective: To investigate the anesthetic effect, safety and feasibility of sevoflurane inhalation combined sacral block in patients undergoing laparoscopic inguinal hernia sac ligation. Methods: A total of 83 children with ASA Ⅰ ~ Ⅱ grade inguinal hernia were enrolled in this study. Laparoscopic ligation of hernia sac was performed. The mask was inhaled with 8% sevoflurane combined oxygen (2 ~ 3 L / min), the eyelash reflex disappeared, the caudal arrest was disappeared after the pain reflex disappeared, and the end-tidal carbon dioxide (PETCO2) Continuous pump with a small amount of propofol pump, intermittent inhalation of sevoflurane. The changes of SPO2, PETCO2, HR, R after anesthesia, pneumoperitoneum, pneumoperitoneum and deflation were observed. Results: 76 cases of complete analgesia, lack of 7 cases, patients with intraoperative muscle relaxants to meet the surgical requirements. After pneumoperitoneum PETCO2 increased significantly, P <0.01, spontaneous breathing can still be compensated, SPO2 stability. Conclusion: Sacral canal blockade is suitable for laparoscopic pediatric inguinal hernia sac high ligation anesthesia to be exact and safe, which can meet the need of operation.