在儿科泌尿外科手术中使用尾状导管进行脊柱麻醉:与全身麻醉的替代方案
Judith Stangl-Kremser1, Kathleen Puttmann1, Seth A Alpert2
1Department of Urology, Ohio State University Wexner Medical Center, Columbus, OH, United States.
Frontiers in pediatrics
|November 21, 2025
概括
脊柱-尾尾导管 (SCC) 麻醉是小儿泌尿外科手术中全身麻醉 (GA) 的可行替代方案. 虽然诱导时间更长,但SCC麻醉减少了手术时间和手术内阿片类药物使用,并发症率相似.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 泌尿外科手术 泌尿外科手术
- 区域麻醉技术 区域麻醉技术
背景情况:
- 儿童复杂的泌尿外科手术通常需要全身麻醉 (GA).
- 评估替代麻醉技术对于优化儿科手术结果至关重要.
- 脊尾导管 (SCC) 麻醉为儿科患者的区域麻醉提供了潜在的好处.
研究的目的:
- 在接受复杂泌尿外科手术的儿童中,与全身麻醉 (GA) 相比,评估脊柱-尾尾导管 (SCC) 麻醉的可行性和结果.
- 为了比较SCC和GA组之间的诱导和操作时间.
- 为了评估手术中药物的使用和麻醉相关的并发症.
主要方法:
- 对接受泌尿外科手术的儿科患者进行回顾性单中心分析.
- 接受SCC麻醉的队列 (2016-2019) 与年龄和程序匹配的GA队列 (2010年以来) 的比较.
- 分析的结果包括诱导/手术时间,手术内药物和并发症.
主要成果:
- 这两个队列都包括52名患者.
- SCC麻醉的诱导时间较长 (平均差异为4分钟,p=0.009),但手术时间较短 (平均差异为34分钟,p<0.001).
- 在SCC组显示较低的手术内阿片类药物使用 (0.014比0.19MED/kg,p<0.001) 和显著较少的皮质类固醇使用 (3.8%比78.8%,p<0.001). 并发症的发生率相似.
结论:
- 脊尾导管 (SCC) 麻醉是复杂的儿科泌尿外科手术中全身麻醉 (GA) 的可行替代方案.
- SCC麻醉的好处包括减少手术时间和手术内阿片类药物需求.
- 虽然诱导时间可能更长,但SCC麻醉可能会减少对气道装置和手术内阿片类药物的需求.
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