丙泊酚联合骶管阻滞对下腹部麻醉患儿的影响

Effect of Propofol combined with sacral block on children undergoing lower abdominal anesthesia

摘要:

目的 探究丙泊酚联合骶管阻滞对下腹部麻醉患儿血流动力学及血清人β 淀粉样蛋白1-42 （Aβ1-42）、人β 淀粉样蛋白1-40（Aβ1-40）的影响。方法 选取2016 年2 月-2017 年4 月在儿童医院行下 腹部手术的患儿73 例作为研究对象，根据随机数字表法分为对照组（36 例）和观察组（37 例）。对照组患儿 采用氯胺酮﹑丙泊酚复合静脉麻醉的麻醉方式，观察组患儿采用丙泊酚联合骶管阻滞的麻醉方式。比较两组 患儿的麻醉效果﹑血流动力学指标﹑血清Aβ1-42 和Aβ1-40 水平及不良反应的发生情况。结果 观察组患儿的 麻醉诱导时间、苏醒时间均短于对照组（P <0.05）；观察组与对照组收缩压、舒张压及心率组内、组间及时 间变化趋势有差异（P <0.05），观察组变化趋势较小；麻醉前后两组患儿Aβ1-40 和Aβ1-42 水平的比较，差异 均无统计学意义（均P >0.05）；观察组患儿各种不良反应的发生率均低于对照组（P <0.05）。结论 丙泊酚联 合骶管阻滞对行下腹部手术的患儿进行麻醉时，麻醉效果好，对血流动力学及血清Aβ1-42、Aβ1-40 的影响小， 因而发挥作用更为平稳、且不良反应的发生率低，值得推广应用。

Abstract:

Objective To investigate the effect of Propofol combined with sacral block on hemodynamics and serum human amyloid beta 1-42 (A beta 1-42) and human amyloid beta 1-40 (A beta 1-40) in children undergoing lower abdominal anesthesia. Methods Totally 70 children who had lower abdominal surgery in our hospital from February 2016 to April 2017 were chosen as the research subjects, and divided into control group (36 cases) and observation group (37 cases) according to the table of random number. Children in the control group received Ketamine and Propofol in intravenous anesthesia, while the children in the observation group received Propofol combined with sacral block for anesthesia. The effects of anesthesia, hemodynamic parameters, serum A beta (1-42), A beta (1-40) and adverse reactions between the two groups were compared. Results The anesthesia induction time and recovery time of the observation group were shorter than those of the control group, and the difference was statically significant (P < 0.05); there was no significant difference in the duration of anesthesia between the two groups (P > 0.05); the variation trend of systolic blood pressure, diastolic blood pressure and heart rate between the observation group and the control group were significantly different (P < 0.05); the variation trend of observation group was smaller than that of the observation group; the differences of the levels of A beta (1-40) and A beta (1-42) before and after anesthesia were not statically significant (P > 0.05); the incidences of adverse reactions in the observation group were lower than that in the control group (P < 0.05). Conclusions Propofol combined with sacral block in children undergoing lower abdominal anesthesia shows better anesthetic effect, while has little influence on hemodynamics, serum A beta (1-42) and A beta (1-40). The incidence of adverse reactions is low and worthy of popularization and application.