探讨超声引导的骶管阻滞与髂腹股沟及髂腹下神经阻滞用于小儿腹腔镜疝囊高位结扎术的临床效果。

随机选取2021年10月至2022年10月在湖北省天门市第一人民医院因腹股沟疝住院进行手术的患儿80例（美国麻醉医师协会分级Ⅰ～Ⅱ级），根据麻醉方式不同将患儿分为Ⅰ组（骶管阻滞组）和Ⅱ组（髂腹股沟及髂腹下神经阻滞组）。监测围手术期各时间节点2组患儿的心率、平均动脉压（MAP）的变化；记录围手术期麻醉效果以及术后不良反应发生情况；在患儿苏醒时，术后4、8、12 h进行疼痛评分和躁动评分。

2组患儿在各时间点的心率、MAP比较，差异均无统计学意义（P>0.05）；术后苏醒后2组患儿在各时间点的疼痛评分比较，差异均无统计学意义（P>0.05）；Ⅱ组麻醉起效时间更快[（3.64±0.86）min比（12.47±2.75）min]，手术结束后患儿躁动发生率Ⅱ组明显更少（7.5%比30%），差异均有统计学意义（P<0.05）；2组患儿手术持续时间、麻醉苏醒时间、术中体动以及术后恶心呕吐、尿潴留、分泌物增多的发生情况比较差异均无统计学意义（P>0.05）。

超声引导下骶管阻滞与髂腹股沟及髂腹下神经阻滞均可安全用于小儿腹腔镜疝囊高位结扎术中，后者起效更快，患儿躁动发生更少，更能满足小儿手术要求。

To investigate the clinical results of ultrasound-guided sacral canal block and ilioinguinal and iliohypogastric nerve block for pediatric laparoscopic high ligation of hernial sac.

A randomized selection of 80 pediatric patients with inguinal hernia who underwent surgery at the First People's Hospital of Tianmen, Hubei Province, from October 2021 to October 2022 were included in the study (American Society of Anesthesiologists grade I-II). The patients were divided into two groups based on the anesthesia method: Group I (caudal block) and Group II (ilioinguinal and iliohypogastric nerve block). The heart rate and mean arterial pressure (MAP) of the two groups were monitored at various perioperative time points. Anesthesia efficacy and postoperative adverse reactions were recorded. Pain and agitation scores were assessed at awakening and at 4, 8, and 12 hours postoperatively.

There were no statistically significant differences between the two groups in terms of heart rate and MAP at various time points (P>0.05). Similarly, there were no significant differences in pain scores at various postoperative time points (P>0.05). Group II exhibited a significantly faster onset of anesthesia [(3.64±0.86) minutes vs (12.47±2.75) minutes] and a lower incidence of postoperative agitation (7.5% vs 30%), both with statistical significance (P<0.05). There were no significant differences between the two groups in terms of surgery duration, anesthesia recovery time, intraoperative body movement, or the incidence of postoperative nausea, vomiting, urinary retention, or increased secretions (P>0.05).

Both ultrasound-guided caudal block and ilioinguinal/iliohypogastric nerve block can be safely used in pediatric laparoscopic high ligation of hernial sac. The latter provides a faster onset of anesthesia and reduces the incidence of postoperative agitation, making it more suitable for pediatric surgical requirements.