Application Of Combined Laryngeal Mask Airway Anesthesia With Sacral Canal Block In Pediatric Surgery Below The Belly Button

ObjectiveTo observe the advantages and disadvantages of laryngeal mask airway anesthesia combined with sacral canal block anesthesia used in pediatric surgery below the belly button, in order to provide reference for clinical anesthesia in children.Methods60 cases of 2～8-year-old children were selected for lower limb or lower abdominal surgery,body weight 10～50kg,ASA I,operative time was 40-180min. Patients were randomly divided into three groups with 20 children in each group. GroupⅠ:group of endotracheal intubation anesthesia combined with sacral canal block anesthesia. GroupⅡ:group of laryngeal mask anesthesia combined with sacral canal block anesthesia and muscle relaxation.GroupⅢ:group of laryngeal mask anesthesia combined with sacral canal block anesthesia and no muscle relaxation.Demographic data,heart rate,non-invasive blood pressure,pulse oximeter oxygen satutraion were recorded for each child.In addition,time from termination of surgery to emergence and removal of the catheter/LMA,side effects were recorded.Results1. BP and HR significantly increased when tracheal tube insertion and removal in groupⅠ,compared with patients in groupⅡwith statistical significance.2. Time from termination of surgery to emergence and removal of the LMA of groupⅡwas significantly shorter than these of groupⅠ(P<0.01),but time of removal of the LMA in groupⅡwas significantly longer than that in groupⅢ(P<0.01).3. Incidence of postoperative adverse events in groupⅡwas lower than that in groupⅠ,differences between groupⅡand groupⅢwere no statistical significance.ConclusionsIn summary,compared with endotracheal anesthesia, laryngeal mask anesthesia has less stimulation on the circulation and shorter recovery time and extubation time and fewer postoperative adverse events.Laryngeal mask anesthesia combined with sacral canal block anesthesia can be safely used in pediatric surgery below the belly button and provide effective postoperative analgesia. The selection of the breathing pattern in surgery should be based on different surgical procedures decision.This study suggests that two hours of minor surgery should be used with spontaneous breathing pattern,while the longer than two hours of surgery or complex surgery should be given muscle relaxants and used with mechanical ventilation pattern.However,it should be noted that the management of airway pressure during the operation and the depth of anesthesia during extubation.