丙泊酚-芬太尼静脉麻复合骶麻在小儿隐匿阴茎手术中的应用
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摘要
目的分析丙泊酚-芬太尼静脉麻复合骶麻在小儿隐匿阴茎手术中的应用效果。方法选取我院于2018年3～11月期间收治的50例隐匿阴茎手术患儿,随机分为两组,对照组与观察组各25例,对照组为单纯咪达唑仑-丙泊酚-芬太尼静脉麻组,观察组为丙泊酚-芬太尼静脉麻复合骶管麻醉组,对比两种麻醉方法的应用效果,观察指标包括丙泊酚、芬太尼、咪达唑仑总用量,术后清醒时间,术中、复苏期不良反应发生率。结果观察组患儿的麻药总用量与术后清醒时间均少于对照组,差异有统计学意义(P <0.05);观察组患儿的术中、复苏期不良反应发生率(8.0%)低于对照组(28.0%),差异有统计学意义(P <0.05)。结论丙泊酚-芬太尼静脉麻复合骶麻在小儿隐匿阴茎手术中的应用效果确切,具有用药少、苏醒时间短、不良反应发生率低、安全性高等优势,是一种较理想的麻醉方法,值得临床推行。
Objective To analyze the application effect of propofol and fentanyl intravenous anesthesia combined with caudal anesthesia in children undergoing concealed penis surgery.Methods 50 children who undergoing concealed penis surgery in our hospital from March 2018 and November 2018 were selected.They were randomly divided into the control group and the observation group,with 25 cases in each group.The control group was given intravenous anesthesia of midazolam,propofol and fentanyl while the observation group was given intravenous anesthesia of propofol and fentanyl combined with caudal anesthesia.The application effects of the two anesthesia methods were compared.The observation indexes included the total dosage of propofol,fentanyl and midazolam,the postoperative waking time and the incidence of adverse reactions during surgery and during the recovery period.Results The total dosage of anesthetics and postoperative waking time in the observation group were both less than those in the control group,and the difference was statistically significant(P < 0.05).The incidence of adverse reactions during surgery and during the recovery period in the observation group(8.0%) was lower than that in the control group(28.0%).The difference was statistically significant(P < 0.05).Conclusion Propofol and fentanyl intravenous anesthesia combined with caudal anesthesia in children undergoing concealed penis surgery has accurate application effects,which has advantages of less drug use,short recovery time,low incidence of adverse reactions and high safety.It is an ideal anesthesia method and worthy of clinical application.
Objective To analyze the application effect of propofol and fentanyl intravenous anesthesia combined with caudal anesthesia in children undergoing concealed penis surgery.Methods 50 children who undergoing concealed penis surgery in our hospital from March 2018 and November 2018 were selected.They were randomly divided into the control group and the observation group,with 25 cases in each group.The control group was given intravenous anesthesia of midazolam,propofol and fentanyl while the observation group was given intravenous anesthesia of propofol and fentanyl combined with caudal anesthesia.The application effects of the two anesthesia methods were compared.The observation indexes included the total dosage of propofol,fentanyl and midazolam,the postoperative waking time and the incidence of adverse reactions during surgery and during the recovery period.Results The total dosage of anesthetics and postoperative waking time in the observation group were both less than those in the control group,and the difference was statistically significant(P < 0.05).The incidence of adverse reactions during surgery and during the recovery period in the observation group(8.0%) was lower than that in the control group(28.0%).The difference was statistically significant(P < 0.05).Conclusion Propofol and fentanyl intravenous anesthesia combined with caudal anesthesia in children undergoing concealed penis surgery has accurate application effects,which has advantages of less drug use,short recovery time,low incidence of adverse reactions and high safety.It is an ideal anesthesia method and worthy of clinical application.
引文
[1]郭宗锋,张法强.不同剂量右美托咪定伍用舒芬太尼在隐匿性阴茎延长术患儿术后静脉镇痛中的应用比较[J].中国现代医学杂志,2016,26(22):104-107.
[2]Garnier S,Maillet O,Cereda B,et al.Late surgical correction of hypospadias increases the risk of complications:a series of 501consecutive patients[J].BJU Int,2017,119(6):942-947.
[3]冯东川,朱孝宇,李圆,等.包皮系带延长阴茎整形术在儿童隐匿阴茎治疗中的应用[J].中华泌尿外科杂志,2017,38(1):38-41.
[4]张小学.小儿隐匿阴茎46例手术治疗[J].中外医学研究,2016,14(15):144-145.
[5]蔡靓羽,张建楠,尹卫娟,等.骶麻复合静脉全身麻醉在小儿隐匿性阴茎延长术的临床麻醉效果[J].中国现代医学杂志,2016,26(24):110-113.
[6]罗兵,李昕.Brisson与Devine两种不同手术治疗小儿隐匿型阴茎疗效观察[J].医学理论与实践,2016,29(16):2218-2219.
[7]魏会霞,罗向红.地佐辛与舒芬太尼预防小儿包皮套扎术麻醉苏醒期躁动的临床效果[J].广西医学,2017,39(10):1578-1579.
[8]Alizadeh F,Fakoor A,Haghdani S.A comparison between tourniquet application and epinephrine injection for hemostasis during hypospadias surgery:The effect on bleeding and postoperative outcome[J].J Pediatr Urol.2016,12(3):160.e1-5.
[9]康力,刘华,陈丽,等.小儿择期手术静脉复合全麻不同剂量瑞芬太尼、丙泊酚全麻维持的量效关系[J].现代中西医结合杂志,2016,25(16):1729-1733.
[10]葛继涛.全凭静脉麻醉与全凭吸入麻醉配合喉罩在小儿日间短小手术中的应用比较[J].中国现代医药杂志,2016,18(3):41-44.
[11]郑昌健,郭文俊,金孝岠.骶管应用右美托咪定对小儿全麻苏醒期躁动的影响[J].皖南医学院学报,2017,36(4):385-388.
[12]贾俊香,李冰,帅斐.对比七氟醚静吸复合麻醉、全凭静脉麻醉(丙泊酚、芬太尼)应用于小儿手术的麻醉质量[J].中外医疗,2017,11(28):144-146.
[13]高锦文,林美玉,黄洁莲,等.丙泊酚、氯胺酮、瑞芬太尼静脉复合麻醉用于小儿隐睾固定术的效果分析[J].药物评价研究,2017,40(3):389-392.
[14]雷伟,雷怀彪,简文静,等.七氟醚静吸复合麻醉与丙泊酚、芬太尼全凭静脉麻醉用于小儿手术的临床效果比较[J].当代医学,2017,23(26):56-57.
[15]金平.阿片类药物用于小儿术后静脉镇痛的研究进展[J].重庆医学,2017,46(10):1419-1421.
[16]张波,叶彦君.骶管阻滞复合舒芬太尼在小儿麻醉的应用观察[J].深圳中西医结合杂志,2016,26(5):115-117.
[2]Garnier S,Maillet O,Cereda B,et al.Late surgical correction of hypospadias increases the risk of complications:a series of 501consecutive patients[J].BJU Int,2017,119(6):942-947.
[3]冯东川,朱孝宇,李圆,等.包皮系带延长阴茎整形术在儿童隐匿阴茎治疗中的应用[J].中华泌尿外科杂志,2017,38(1):38-41.
[4]张小学.小儿隐匿阴茎46例手术治疗[J].中外医学研究,2016,14(15):144-145.
[5]蔡靓羽,张建楠,尹卫娟,等.骶麻复合静脉全身麻醉在小儿隐匿性阴茎延长术的临床麻醉效果[J].中国现代医学杂志,2016,26(24):110-113.
[6]罗兵,李昕.Brisson与Devine两种不同手术治疗小儿隐匿型阴茎疗效观察[J].医学理论与实践,2016,29(16):2218-2219.
[7]魏会霞,罗向红.地佐辛与舒芬太尼预防小儿包皮套扎术麻醉苏醒期躁动的临床效果[J].广西医学,2017,39(10):1578-1579.
[8]Alizadeh F,Fakoor A,Haghdani S.A comparison between tourniquet application and epinephrine injection for hemostasis during hypospadias surgery:The effect on bleeding and postoperative outcome[J].J Pediatr Urol.2016,12(3):160.e1-5.
[9]康力,刘华,陈丽,等.小儿择期手术静脉复合全麻不同剂量瑞芬太尼、丙泊酚全麻维持的量效关系[J].现代中西医结合杂志,2016,25(16):1729-1733.
[10]葛继涛.全凭静脉麻醉与全凭吸入麻醉配合喉罩在小儿日间短小手术中的应用比较[J].中国现代医药杂志,2016,18(3):41-44.
[11]郑昌健,郭文俊,金孝岠.骶管应用右美托咪定对小儿全麻苏醒期躁动的影响[J].皖南医学院学报,2017,36(4):385-388.
[12]贾俊香,李冰,帅斐.对比七氟醚静吸复合麻醉、全凭静脉麻醉(丙泊酚、芬太尼)应用于小儿手术的麻醉质量[J].中外医疗,2017,11(28):144-146.
[13]高锦文,林美玉,黄洁莲,等.丙泊酚、氯胺酮、瑞芬太尼静脉复合麻醉用于小儿隐睾固定术的效果分析[J].药物评价研究,2017,40(3):389-392.
[14]雷伟,雷怀彪,简文静,等.七氟醚静吸复合麻醉与丙泊酚、芬太尼全凭静脉麻醉用于小儿手术的临床效果比较[J].当代医学,2017,23(26):56-57.
[15]金平.阿片类药物用于小儿术后静脉镇痛的研究进展[J].重庆医学,2017,46(10):1419-1421.
[16]张波,叶彦君.骶管阻滞复合舒芬太尼在小儿麻醉的应用观察[J].深圳中西医结合杂志,2016,26(5):115-117.