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目的:探讨连续骶管阻滞麻醉在小儿较长时间手术中的应用效果。方法:术前30 m in肌内注射哌替啶,氟哌利多和阿托品,1岁以下不用哌替啶。在氯胺酮基础麻醉下,左侧卧位辨明骶裂孔,用左手拇指固定,使用贝朗公司提供的22G管内针与皮肤约45°角向头端进针,穿过骶尾韧带有突破感后再送入套管。回抽无血、无液,先注试验剂量,观察无异常后再注全量。根据不同年龄采用0.8%~1.5%利多卡因,每隔60 m in追加局麻药,药量为首次剂量的1/2。术中常规监测ECG、HR、RR、BP、SpO2和T。结果:本组全部顺利完成手术,麻醉效果满意。术中生命体征平稳,对循环影响小,静脉麻醉种类和用量明显减少。无麻醉意外及骶管穿刺后并发症。结论:采用连续骶管阻滞技术可根据手术需要,延长麻醉时间,减少静脉药量,满足手术需要,且操作简便,生理干扰小。
Objective: To investigate the effect of continuous caudal block anesthesia in pediatric long-term surgery. METHODS: Pethidine, droperidol, and atropine were administered intramuscularly 30 min prior to surgery, and no pethidine was administered to patients under 1 year of age. Under ketamine-based anesthesia, the left lateral decubitus was identified with sacral fissures and the left thumb was used. A 22G cannula provided by Beilan Corporation was inserted into the tip of the head at a 45 ° angle to the skin, followed by a sensation of breakthrough through the sacrococcygeal ligament Into the casing. Draw back no blood, no liquid, first note the test dose, no abnormal observation after the injection of the full amount. According to different age with 0.8% to 1.5% lidocaine, additional local anesthetic every 60 m in, the dose for the first dose of 1/2. Intraoperative ECG, HR, RR, BP, SpO2 and T are routinely monitored. Results: All the patients in this group successfully completed the operation and the anesthetic effect was satisfactory. Intraoperative vital signs stable, little effect on the circulation, type and amount of intravenous anesthesia significantly reduced. No complications after anesthesia and caudal puncture. Conclusion: The continuous caudal block technique can prolong the anesthesia time, reduce the intravenous dose, meet the need of operation according to the needs of operation, and it is easy to operate and less physiological interference.