段慧

摘要：目的：探讨单次骶管阻滞麻醉用于小儿烧伤科日间手术的可行性和安全性。方法：80例烧伤科日间手术患儿随机分为两组，每组40例，Ⅰ组在氯胺酮基础麻醉下行单次骶管阻滞，Ⅱ组行静脉全身麻醉。记录患儿术中术后生命体征和可能发生的并发症。结果：Ⅰ组患儿术中呼吸循环系统变化不大，术后恶心、呕吐、躁动、谵妄等并发症的发生率低于Ⅱ组，术后患儿较Ⅱ组苏醒快而完全。结论：单次骶管阻滞应用于小儿烧伤科日间手术具有麻醉效果好，生命体征平稳，不良反应更少，术后患儿离院更早的优点，值得推广。

关键词：单次骶管阻滞；小儿；烧伤；日间手术

Abstract：Objective：To explore the feasibility and safety of the simple caudal anesthesia in pediatric patients undergoing day surgery of burn.【Methods】Totally 80 pediatric patients undergoing day surgery of burn were randomly divided into groupⅠ（40cases）and groupⅡ（40cases）.GroupⅠwas treated with the simple caudal anesthesia after ketamine 2mg/kg was used for the induction of anesthesia. GroupⅡwas treated with intravenous anesthesia.Vital signs and adverse effects during operation and postoperative awakening period were recorded.【Results】 pediatric patients of groupⅠhad little change in respiratory system and cardiovascular system during operation.The incidence of complications，such as postoperative nausea、vomiting、agitated delirium was lower than groupⅡ，In addition，awoke quickly and completely after operation.【Conclusion】Application of the simple caudal anesthesia in pediatric patients undergoing day surgery of burn can provide good effect of anesthesia，vital signs smoothly， adverse reactions less，the departure from hospital earlier，It is worthy to be popularized.

Keywords：the simple caudal；pediatric；burn；day surgery

日间手术亦称非住院手术，当日归宅手术，即需要住院实施手术的患者于当日来院，术后经恢复室观察，24小时内回家。据国外资料统计，其在欧美发达国家开展已有十几年历史。我院作为烧伤专科医院，每年收治的小儿患者占病人总数的70%以上，传统的收住院安排择期手术方式，存在住院时间长，医疗费用高等缺点，尤其是小儿患者，住院期间易发生交叉感染，同时各种不良刺激易致儿童心理创伤。近年来，我院逐步开展日间手术，尝试筛选出最与之匹配的麻醉方法。小儿烧烫伤往往累及肢体，使用基础全麻+神经阻滞的方式能较好的满足手术要求。

1资料和方法

1.1 一般资料 80例烧伤科日间手术患儿，其中男56例，女24例，年龄6/12岁～6岁，体重6～24kg，受伤部位均为下肢，择期行清创植皮手術，手术时间30～70min。所有患儿不合并其它系统疾病，近期均无上呼吸道感染史，智力及语言发育正常。……