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我院1994年1月～1997年11月对134例1岁以内的婴儿手术病人行硬膜外阻滞,现总结体会如下。资料与方法 134例病人中,男74例,女60例,年龄20天～1岁,体重3～11kg,平均6.84±1.76kg。疾病种类分别为闭肛15例。肠套叠18例,肾母细胞瘤17例,先天性巨结肠30例,肾胚胎瘤15例,畸胎瘤8例,双输尿管畸形6例,双肾积水2例,消化道出血2例,其它腹部手术23例。麻醉方法:在氯胺酮基础麻醉复合连续硬膜外阻滞。局麻药为0.7%～1%利多卡因。常规监测心率、氧饱和度、血压监测。术中病人常规面罩吸氧。结果 122例手术病人硬膜外阻滞效果满意,肌松良好,12例手术病人麻醉效果及肌松欠佳。56例病人出现心动过缓,24例出现血压下降。无舌后坠、呼吸道梗阻和呼吸抑制出现。1例患儿出现心力衰竭、肺水肿。讨论 (1)婴儿脊柱平直,腔内间隙相对较小。穿刺点选择较成人低2～3个节段。婴儿神经细,鞘膜薄,选用利多卡因的浓度为0.7%～1%,因腔内组织疏松,
Our hospital from January 1994 to November 1997 134 cases of infants under the age of 1 surgery patients with epidural block, are summarized as follows. Materials and Methods 134 cases of patients, 74 males and 60 females, aged 20 days to 1 year old, weighing 3 ~ 11kg, an average of 6.84 ± 1.76kg. Disease types were closed anus in 15 cases. Intussusception in 18 cases, Wilms tumor in 17 cases, congenital megacolon in 30 cases, renal tumor in 15 cases, teratoma in 8 cases, double ureteral deformity in 6 cases, 2 cases of hydronephrosis, gastrointestinal bleeding in 2 cases Other abdominal surgery in 23 cases. Anesthesia Methods: Ketamine Base Anesthesia Compound Continuous Epidural Block. Local anesthetics are 0.7% ~ 1% lidocaine. Routine monitoring of heart rate, oxygen saturation, blood pressure monitoring. Intraoperative patients routine mask oxygen. Results 122 cases of surgical patients with satisfactory results of epidural block, good muscle relaxation, 12 cases of surgical anesthesia and muscle relaxation effect poor. 56 cases of patients with bradycardia, 24 cases of blood pressure dropped. No tongue fall, respiratory obstruction and respiratory depression appear. One patient developed heart failure and pulmonary edema. Discussion (1) Baby spine straight, relatively small gap within the cavity. Puncture point selection lower than adults 2 to 3 segments. Infant nerve fine, thin sheath, the choice of lidocaine concentration of 0.7% to 1%, due to loose intraluminal tissue,