贾淑芬

摘要：目的 对小儿手术选择硬膜外麻醉联合超前多模式镇痛方案的应用效果进行观察分析。方法 于本院接受下肢及会阴位置手术治疗患儿中筛选70例纳入研究。依据麻醉方案不同进行分组，手术时仅接受硬膜外麻醉纳入对照组，同时联合实施超前多模式阵痛纳入观察者，对比两组阵痛效果及不良反应。结果 观察组术后4h、8h疼痛评分均低于对照组，麻醉完善率高于对照组（P<0.05）;两组患儿各时间节点各项生命体征指标平稳且无明显差异（P>0.05）;两组手术及麻醉过程中均未发生不良反应。结论 选择硬膜外麻醉联合超前多模式镇痛方案，术中可获得更加理想麻醉效果，显著提升术后阵痛效果，且安全性理想，值得推广应用于临床中。

关键词：小儿手术;硬膜外麻醉;超前多模式镇痛;应用效果

[Abstract] Objective To observe and analyze the application effect of epidural anesthesia combined with advanced multimodal analgesia in pediatric surgery. Methods a total of 70 children with lower extremity and perineal surgery were enrolled in the study. The patients were divided into two groups according to different anesthesia schemes. The patients who only received epidural anesthesia during operation were included in the control group，and the patients who combined with advanced multimodal labor pain were included in the observation group. The labor pain effect and adverse reactions of the two groups were compared. Results the pain scores at 4H and 8h after operation in the observation group were lower than those in the control group，and the improvement rate of anesthesia in the observation group was higher than that in the control group（P < 0.05）;The vital signs of the two groups were stable at each time point，and there was no significant difference（P > 0.05）;There were no adverse reactions during operation and anesthesia in the two groups. Conclusion epidural anesthesia combined with advanced multimodal analgesia can obtain more ideal anesthesia effect，significantly improve the effect of postoperative labor pain，and the safety is ideal，which is worthy of clinical application.

[Key words] pediatric surgery;Epidural anesthesia;Preemptive multimodal analgesia;Application effect

与成人相比，儿童由于器官、组织以及身体机能都未发育完善，在治疗过程中更容易发生麻醉不良事件【1】，选择合适的麻醉方案是确保手术效果的关键。连续硬膜外麻醉有创且会诱发出血，且有较高几率发生阻滞不全，手术过程中无法确保血流动力学稳定并确切降低应激反应【2-3】。为了进一步提升小儿手术麻醉效果及安全性，本次研究对接受下肢及会阴位置手术治疗患儿选择硬膜外麻醉联合超前多模式镇痛方案，重点观察其应用效果及安全性。报道如下。

1 一般资料与方法

1.1 一般资料

于本院接受下肢及会阴位置手术治疗患儿中筛选70例纳入研究，收集时间为2019年10月-2020年12月，依据麻醉方案不同进行分组。……