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1、硬膜外阻滞辅以全麻在小儿手术治疗中应【中图分类号】R614.2【文献标识码】A【文章编号】1672-6383-(2010)12-0067-02【摘要】目的：本文对我院自2007年8月至2010年8月在硬膜外阻滞辅以全麻用于小儿手术的临床效果进行总结。方法：30例手术患儿随机分为单纯全麻I组和硬膜外辅以全麻II组，每组15例。观察两组病人循环功能的改变、术中全麻药的用量、手术部位肌松程度及术毕清醒时间。结果:两组病人一般情况、手术时间无明显差异(P>0.05)o血压、心率于术前、术中、术毕清醒时有明显差异(P<0.05)o苏醒时
2、间组间相比有明显差异性(P<0.01)，术中麻醉用药两组间有明显差异(P<0.01)，手术部位肌松程度有明显差异。结论:硬膜外阻滞辅以全麻用于小儿手术患儿循环系统更平稳、全麻用药量小，患儿苏醒快，肌松程度更满意。【关键词】硬膜外阻滞；全麻；小儿Outsidethehardmembranehindersauxiliarybythegeneralanesthesia,intheyoungchildsurgerytreatstheapplicationWeiQimei[Abstract】Objective:Thisarticle-2
3、010yearinAugusthinderstomycourtyardfromAugust,2007outsidethehardmembraneauxiliarytouseintheyoungchildsurgery'sclinicaleffectbythegeneralanesthesiacarryingonthesummary.Method:30examplesurgerybabydividesintothepuregeneralanesthesiaIgroupstochasticallywiththehardmembra
4、neoutsideauxiliarybythegeneralanesthesiallGroup,eachgroupof15examples.Observestwogroupofpatientloopfunctioninthechange,thetechniquetheentireanestheticamountused,thesurgeryspotmyo-loosedegreeandthetechniquefinishesthesobertime・Finally:Twogroupofpatientordinarycircums
5、tances,surgerytimenotobviousdifferenee(P>0.05).Thebloodpressure,theheartrateinthetechnique,thetechnique,thetechniquefinishissoberwhenhavetheobviousdifference(P<0.05)oTheregainingconsciousnesstimegroupcompareshastheobviousdifferenee(P<0.01),Inthetechniqueanaesthetize
6、sappliesdrugsduringtwogroupstohavetheobviousdifference(P<0.01),Thesurgeryspotmyoloosedegreehastheobviousdifferenee.Conclusion:Outsidethehardmembranehindersauxiliarytouseintheyoungchildsurgerybabycirculatorysystembythegeneralanesthesiabeingsteadier,thegeneralanesthes
7、iatobesmallwiththedose,thebabyregainsconsciousnessquickly,themyo-loosedegreeismoresatisfied・[Keywords]Outsidethehardmembranehinders;Generalanesthesia;Youngchild1临床资料1.1病例：全组30例，男18例、女12例，年龄3-12岁,体重11.5-30kg,ASA为I〜II级。腹腔镜下阑尾切除术10例，鞘膜积液翻转术6例，经腹斜疝高位结扎术6例,下肢手术4例，开腹阑尾切除术
8、2例，腹腔镜下斜疝高位结扎术2例。1.2麻醉方法：患儿入手术室后缓慢静脉注射氯胺酮1~2mg/kg或肌肉注射氯胺酮5~7mg/kg,待神志消失后,II组将患儿置于左侧卧位选用直入法行硬膜外腔穿刺，穿刺部位L1-L2间隙穿刺成功确认无误后将2%利多卡因0.75%布比卡因：生理盐
