静脉套管针在小儿单次腰麻中的应用

【关键词】 ,,套管针

摘 要：目的：研究静脉套管针应用于小儿单次蛛网膜下隙阻滞麻醉（腰麻）的可行性。方法：择期行下腹部、下肢手术的患儿60例，年龄6月～6岁，ASAⅡ级,随机分为A、B两组。A组用22G或24G国际通用型号静脉套管针针芯行腰麻,B组以氯胺酮行全凭静脉麻醉, 术中均辅以咪达唑仑镇静。记录患儿血压、心率、脉搏血氧饱和度、呼吸频率，记录使用静脉药的剂量，苏醒时间及不良反应。结果：麻醉效果满意，两组患儿血压、心率术中各时点差别有统计学意义（P＜0.05），脉搏血氧饱和度、呼吸频率差别无统计学意义，A组苏醒时间较B组短，差别有统计学意义（P＜0.05），A组不良反应较B组少。结论：采用静脉套管针针芯穿刺进行腰麻，用于小儿下腹部、下肢手术麻醉，可取得满意效果。

　　关键词： 套管针； 小儿； 单次 ； 麻醉； 脊髓

　　The Application of Trocar in Single Spinal Anesthesia of Children

　　Abstract： Objective： To study the feasibility of the needle core of trocar used in single spinal anesthesia of children. Method： Sixty children (aged 6M～6Y,ASA II ,scheduled for operation of upper abdomen or lower extremity) were randomly divided into two groups: group A was single spinal anesthesia ,group B was intravenous anesthesia. Group A was used the needle core of trocar of 22G or 24G for single spinal anesthesia, and group B was used ketamine for intravenous anesthesia. Both groups were assisted midazolam for sedation. Recording the BP, HR, SpO2 and RR. Recording the quantity of intravenous anesthetics, awaking time and side effects. Result：The anesthesia effect was satisfied. It was significantly difference of BP, HR during the operation (P＜0.05). The awaking time of group A was shorter than group B, and it was significantly difference (P＜0.05). The side effects of group A was fewer than group B. Conclusion： Using the needle core of trocar for the single spinal anesthesia of children scheduled for operation of upper abdomen or lower extremity is feasibility.

　　key words： Trocar； Children； Single； Anesthesia； Spinal

　　我们采用静脉套管针针芯进行腰麻，用于小儿下腹部、下肢手术麻醉，取得满意效果。

　　1 资料与方法

　　1．1 一般资料：择期行下腹部、下肢手术的患儿60例，年龄6月～6岁，ASAⅡ级。依对应年龄、体重和手术随机分为A、B两组（n=30），A组为腰麻组，B组为全凭静脉麻组。

　　1．2 麻醉方法：患儿术前禁食6h，术前30min肌注鲁米那4～6mg/kg、海俄辛0.01～0.02mg/kg。入室时予肌注氯胺酮5～7mg/kg，入睡后面罩吸氧并建立静脉通道，静滴5%葡萄糖盐水4～10ml/(kg