Abstract：Objective To investigate the clinical effect of sacral canal block guided by ultrasound in the correction of developmental dislocation of the hip in children.Methods Seventy cases of children under developmental hip dislocation correction in our hospital between June 2016 and June 2018 were selected and randomly divided into two groups, with 35 cases in each. The experimental group underwent sacral canal block under ultrasound guidance while the control group received lumbar epidural block using 0.2% ropivacaine. The puncture status of patients in both groups was recorded, so were the changes of ropivacaine dosage, BP and HR. Intraoperative fentanyl dosage was recorded. The pain FLACC score at 2, 4, 6, 12, 24 h and 48h after surgery and the time acetaminophen was used for the first time were recorded. The sleep disturbance sedation score (Ramsay score) of the children was recorded to evaluate the sedation of the children 12 hours after surgery. Postoperative complications were also recorded.Results The number of times needle penetration was adjusted in the experimental group was significantly smaller than that in the control group (P<0.05).The puncture time of the experimental group (13.42±2.50) min was longer than that of the control group (5.73±2.12) min (P<0.05). The dosage of ropivacaine in the experimental group was higher than that in the control group (P<0.05). There was no significant difference in the intraoperative fentanyl dosage between the two groups.In the experimental group, the time acetaminophen was used for the first time after surgery (19.6±3.2) h was significantly later than in the control group (11.4±4.1) h (P<0.05). Twelve hours after surgery, the FLACC score of the experimental group (1.6±0.9) was significantly lower than that of the control group (4.3±1.5), P<0.05.However, Ramsay score of the experimental group was higher than that of the control group 12 h after surgery (P<0.05).Conclusions Sacral canal block guided by ultrasound in pediatric DDH correction can provide effective analgesia 24h after surgery, which is worthy of wider application.
杨小宇. 小儿发育性髋脱位矫正术超声引导下骶管阻滞麻醉效果[J]. 武警医学, 2019, 30(8): 672-675.
YANG Xiaoyu. The clinical effect of sacral canal block guided by ultrasound in correction of developmental dislocation of hips in children. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(8): 672-675.
Bang S, Chung J, Jeong J, et al. Efficacy of ultrasound-guided fascia iliaca compartment block after hip hemiarthroplasty: A prospective, randomized trial[J]. Medicine,2016,95(39):e5018.
Wang X, Xu S, Qin X, et al. Comparison between the use of ropivacaine alone and ropivacaine with sufentanil in epidural labor analgesia[J]. Medicine,2015,94(43):e1882.
[5]
Lnnqvist PA, Ecoffey C, Bosenberg A, et al. The european society of regional anesthesia and pain therapy and the american society of regional anesthesia and pain medicine joint committee practice advisory on controversial topics in pediatric regional anesthesia I and II: what do they tell us[J]. Curr Opin Anaesthesiol,2017,30(5):613-620.
[6]
Peled E,Eidelman M,Katzman A,et al.Neonatal incidence of hip dysplasia:len years of experience[J].Clin Orthop Relat Res,2008,466(4):771-775.
[7]
Bayne CE, Cardona-Grau D. Featuring: prospective study of enhanced recovery after surgery protocol in children undergoing reconstructive operations[J]. J Pediatr Urol,2018,14(2):192-193.
[8]
Gan TJ, Scott M, Thacker J, et al. American society for enhanced recovery. advancing enhanced recovery and perioperative medicine[J]. Anesth Analg,2018,126(6): 1870-1873.
[9]
Richa F, Chalhoub V. Dexmedetomidine as an adjunct for pediatric caudal anesthesia: how useful[J].Minerva Anestesiol,2018,84(7):780-782.
2019, Vol. 30 
