Application value of ultrasound-guided caudal anesthesia in infants for pediatric hernia surgery

doi:10.3877/cma.j.issn.1674-392X.2019.03.008

Abstract

Abstract:

Objective

To study on the application value of ultrasound-guided caudal anesthesia in infants for pediatric hernia surgery.

Methods

100 children were treated with pediatric hernia surgery in Army Characteristic Medical Center from January 2016 to December 2016. They were considered as study objects and the clinical data were analyzed retrospectively. They were divided into observation group (n=52) and control group (n=48). The patients were treated with ultrasound-guided caudal anesthesia in the observation group, while the patients were treated with positioning of sacral puncture by resistance disappearance technique in the control group. The anesthetic effect was observed and compared.

Results

(1) Puncture time, number of puncture, dosage of ketamine, time to leave operating room after operation and postoperative recovery time in the observation group were significantly lower than the control group (P<0.05); (2) Sacral block success rate in the observation group was significantly higher than the control group (P<0.05); (3) Postoperative analgesic effect in the observation group was significantly better than the control group (P<0.05); (4) The restlessness score and postoperative pain scores (at 2, 4 and 8 hours after operation) in the observation group were significantly lower than the control group (P<0.05); (5) Before pneumoperitoneum, there was no statistically significant difference in the comparison of HR, MAP and PetCO₂ between the two groups (P>0.05). After pneumoperitoneum, HR, MAP and PetCO₂ levels in the observation group were significantly higher than those in the control group (P<0.05). However, there was no significant difference in BP, SpO₂ and pH before and after treatment (P<0.05). (6) The incidence of adverse reactions in the observation group was significantly lower than the control group (P<0.05).

Conclusion

Ultrasound guided caudal anesthesia applied in pediatric hernia surgery has the advantages of accurate positioning, short recovery time, and better analgesic effect. Besides, it can reduce the restlessness in awakening period and improve the blood gas and circulation. This method is safe and effective, being worthy of further clinical promotion and application.

Key words: Ultrasound-guided, Caudal anesthesia, Hernia surgery in infants, Application value

Wei Chen, Xian Chen, Jun Zhang. Application value of ultrasound-guided caudal anesthesia in infants for pediatric hernia surgery[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(03): 221-225.

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References 19

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组别	例数	感觉阻滞起效时间(s)	运动阻滞起效时间(s)	术后苏醒时间(min)
观察组	52	31.23±5.67	100.98±12.43	22.45±5.76
对照组	48	45.32±6.43	129.64±10.65	31.42±6.73
t值		11.642	12.332	7.977
P值		<0.001	<0.001	<0.001

组别	例数	感觉阻滞起效时间(s)	运动阻滞起效时间(s)	术后苏醒时间(min)
观察组	52	31.23±5.67	100.98±12.43	22.45±5.76
对照组	48	45.32±6.43	129.64±10.65	31.42±6.73
t值		11.642	12.332	7.977
P值		<0.001	<0.001	<0.001

组别	例数	穿刺时间(min)	穿刺次数(次)	氯胺酮使用剂量(mg)	离手术室时间(min)
观察组	52	3.76±1.01	1.23±0.56	41.72±12.76	36.74±5.58
对照组	48	5.43±1.76	1.98±0.68	70.74±16.67	42.76±8.63
t值		5.875	6.039	9.819	11.107
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	穿刺时间(min)	穿刺次数(次)	氯胺酮使用剂量(mg)	离手术室时间(min)
观察组	52	3.76±1.01	1.23±0.56	41.72±12.76	36.74±5.58
对照组	48	5.43±1.76	1.98±0.68	70.74±16.67	42.76±8.63
t值		5.875	6.039	9.819	11.107
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	骶管阻滞成功	一次穿刺成功
观察组	52	48(92.31)	42(80.77)
对照组	48	32(66.67)	28(58.33)
χ²值		8.716	4.962
P值		0.003	0.026

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