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目的:研究七氟醚复合小剂量肌松镇痛药在小儿腹腔镜疝气手术应用的可行性。方法:选择我院收治的单侧腹股沟斜疝行腹腔镜疝囊高位结扎术患儿60例,随机分为两组,A组(高浓度七氟醚吸入,静注小剂量0.05 mg/kg维库溴胺和2μg/kg芬太尼插管组)和B组(高浓度七氟醚吸入,静注常规剂量0.1 mg/kg维库溴胺和3μg/kg芬太尼插管组),每组30例,术中用七氟醚维持,观察并记录两组患儿术中不同时间段血流动力学参数、苏醒及拔管时间、术中不良反应。结果:两组患儿血氧饱和度(Sp O2)均无明显影响,没有造成缺氧;建立气腹后生命体征及气道压和呼气末二氧化碳(PETCO2)均有不同程度升高,未造成二氧化碳(CO2)蓄积,A组苏醒拔管时间明显短于B组。结论:七氟醚复合小剂量肌松镇痛药用于小儿腹腔镜疝气手术麻醉的方法是安全有效的,缩短患儿术后苏醒和拔管时间,提高手术周转率。
Objective: To study the feasibility of sevoflurane combined with small dose of muscle relaxant analgesics in pediatric laparoscopic hernia surgery. Methods: Sixty children with laparoscopic hernia sac ligation undergoing unilateral inguinal hernia in our hospital were randomly divided into two groups. Group A (high concentration sevoflurane inhalation, low dose 0.05 mg / kg dimension intravenous injection) Clobromide and 2μg / kg fentanyl intubation group) and group B (high concentration sevoflurane inhalation, intravenous conventional dose of 0.1mg / kg vecuronium and 3μg / kg fentanyl intubation group), each (N = 30) .Serum sevoflurane was used to maintain the hemodynamics, recovery and extubation time and adverse reactions in the two groups during operation. Results: No significant effect was found on the oxygen saturation (Sp O2) and no hypoxia was observed in both groups. The vital signs, airway pressure and end-tidal carbon dioxide (PETCO2) after pneumoperitoneum were established were all increased to varying degrees, Resulting in the accumulation of carbon dioxide (CO2), A group awake extubation time was significantly shorter than the B group. Conclusion: Sevoflurane combined with small dose of muscle relaxant analgesics for pediatric laparoscopic hernia surgery is safe and effective, which can shorten the postoperative recovery and extubation time and improve the operation rate.