比较单用喉罩全身麻醉或喉罩全身麻醉联合骶管阻滞在儿童疝囊高位结扎术中的效果。

选择2018年6月至2020年5月，在广元市中心医院接受日间手术的疝囊高位结扎术患儿100例为研究对象，按随机数字表法分为喉罩全身麻醉联合骶管阻滞组（S组）和单用喉罩全身麻醉组（L组），每组50例。S组诱导前用0.1%罗哌卡因1 ml/kg行骶管阻滞。2组麻醉诱导和维持方式相同，诱导后插入喉罩，行机械通气。术毕拔除喉罩，送麻醉恢复室。记录2组入室时（T₀）、插入喉罩后（T₁）、手术开始时（T₂）、拔除喉罩后（T₃）的平均动脉压（MAP）和心率。记录2组手术时间、麻醉时间以及瑞芬太尼和七氟醚的用量。采用行为学评分法（CRIES评分）评价患儿术后疼痛程度，记录补救镇痛率。记录2组下肢运动功能评分（Bromage评分）和尿潴留的发生率。

2组患儿性别构成、年龄、体重以及手术时间和麻醉时间比较差异无统计学意义（P>0.05）。不同时相收缩压和心率差异有统计学意义（P<0.05）。组间比较，L组MAP和心率在T₂时较S组增加，差异有统计学意义（P<0.01），组内与T₀比较，S组MAP和心率在T₁和T₂时降低，L组MAP和心率在T₁时降低，差异有统计学意义（P<0.01）。S组瑞芬太尼和七氟醚的用量较L组显著减少，CRIES评分和补救镇痛率较L组显著降低，差异有统计学意义（P<0.01）。2组术后Bromage评分和尿潴留的发生率比较差异无统计学意义（P>0.05）。

喉罩全身麻醉联合骶管阻滞在儿童疝囊高位结扎术中麻醉效果好，血流动力学稳定，并发症少，有利于患儿术后早期康复。

To compare the effect of laryngeal mask airway general anesthesia alone versus laryngeal mask anesthesia combined with sacral block in high ligation of hernia sac in children.

From June 2018 to May 2020, 100 children of high ligation of hernia sac in Guangyuan Central Hospital were selected as subjects and randomly divided into laryngeal mask anesthesia combined with sacral block group (group S) and laryngeal mask anesthesia alone group (group L) using a random number table method, with 50 cases in each group. Before induction, 0.1% ropivacaine 1 ml/kg was used for sacral block in group S. Anesthesia induction and maintenance methods were the same in the two groups. After induction, laryngeal mask airway was inserted and mechanical ventilation was performed. The laryngeal mask was removed and patient was sent to anesthesia recovery room after operation. Mean arterial pressure (MAP) and heart rate (HR) of the two groups were recorded at the time of entering the room (T₀), after laryngeal mask insertion (T₁), at the beginning of operation (T₂) and after removing laryngeal mask (T₃). The operation time, anesthesia time and the dosage of remifentanil and sevoflurane were recorded in the two groups. Postoperative pain was evaluated by CRIES score, and the rate of rescue analgesia was recorded. The lower limbs motor function score (Bromage score) and incidence of urinary retention were recorded in the two groups.

There was no significant difference in gender composition, age, weight, operation time and anesthesia time between the two groups (P>0.05). There were significant differences in MAP and HR at different time points (P<0.05). Compared with group S, MAP and HR in group L were significantly increased at T₂ (P<0.01). Compared with T₀, MAP and HR in group S were significantly decreased at T₁ and T₂, while MAP and HR in group L were significantly decreased at T₁ (P<0.01). The dosage of remifentanil and sevoflurane in group S was significantly lower than that in group L, the scores of CRIES and the rate of rescue analgesia in group S were significantly lower than those in group L (P<0.01). There was no significant difference in Bromage score and the incidence of urinary retention between the two groups (P>0.05).

Laryngeal mask airway general anesthesia combined with sacral block in high ligation of hernia sac in children has good anesthetic effect, stable hemodynamics and fewer complications, which is conducive to the early recovery of children after operation.