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目的通过应用不同浓度的利多卡因对1～3个月的婴儿进行骶管阻滞,观察不同浓度利多卡因的安全性及有效性。方法选择2009-2012年于广州市妇女儿童医疗中心因双侧马蹄足需行跟腱切断术的90例婴儿作为研究对象,采用随机数字法分为A、B、C组,分别用0.5%、1%、1.5%利多卡因行骶管阻滞麻醉。观察骶管阻滞前(T1)、骶管阻滞后10min(T2)、切皮时(T3)、术毕时(T4)各时点心率(HR)、收缩压(SBP)、舒张压(DBP)、呼吸频率(RR)、心电图(ECG)变化及术后4、8h患儿对疼痛刺激的反应。结果切皮时,A组与B、C组比较HR、SBP、DBP、RR差异有统计学意义(P<0.05),其余各时间点各组间比较无统计学意义(P>0.05),三组中ECG也未发现有异常改变,术后4、8h后双侧足趾疼痛刺激时双髋屈曲反应正常。A组患儿在切皮时有6例因体动需要静脉追加氯胺酮。结论 0.5%～1.5%利多卡因用于婴儿骶管阻滞安全有效,其中1%利多卡因更适合。
Objective To observe the safety and efficacy of lidocaine at different concentrations by applying caudal block to infants of 1 to 3 months with different concentrations of lidocaine. Methods From 2009 to 2012, 90 infants who received Achilles Tendon rupture on both sides of the clubs in Guangzhou Women and Children’s Medical Center were divided into groups A, B and C by random number method, 1%, 1.5% lidocaine sacral block anesthesia. The changes of heart rate (HR), systolic pressure (SBP) and diastolic blood pressure (SBP) before sacral block (T1), caudal sac 10min (T2), incision (T3) DBP, respiratory rate (RR), electrocardiogram (ECG) and the response to pain stimuli in children 4 and 8 hours after operation. Results There was a significant difference in HR, SBP, DBP and RR between group A and group B and group C (P <0.05), while there was no significant difference between the groups at other time points (P> 0.05) No abnormal changes of ECG were found in the group. The flexion reaction of double hip was normal after stimulation of bilateral toe pain 4 and 8 hours after operation. A group of children in the skin incision in 6 cases due to body movement need intravenous ketamine. Conclusion 0.5% ~ 1.5% lidocaine is safe and effective for sacral block in infants, and 1% lidocaine is more suitable.