标题：骶管阻滞复合全麻在小儿腹腔镜手术中的临床效果和不良反应的Meta分析

      作者：沈孜颖，夏中元，赵 博，冷 燕，刘 敏，侯家保
    (武汉大学人民医院麻醉科，湖北 武汉 430060)

      卷次： 2015年26卷20期

      【摘要】 目的 采用Meta分析的方法系统评价骶管阻滞复合气管插管全麻在小儿腹腔镜手术中的临床效
果和不良反应。方法 计算机检索 PubMed、Embase、Cochrane Library、中国知网、维普、万方数据库从建库至
2014年10月的文献，对符合纳入与排除标准的研究进行资料提取和文献质量评价，并采用RevMan 5.1.5软件进
行Meta分析。结果 最终纳入9个随机对照实验，共计患者528例。Meta分析结果显示，与单纯全麻比较，骶管
阻滞复合气管插管全麻：①循环指标心率(HR)更平稳，在气管插管前、气腹后 15 min和拔管后差异有统计学意
义；②呼吸指标呼气末二氧化碳分压(PETCO2)更平稳，在气腹后15 min差异有统计学意义；③诱导时间、苏醒时间
以及拔管时间更短，差异有统计学意义；④术后不良反应：复合骶管阻滞组明显少于单纯全麻组，苏醒期躁动、术
后恶心呕吐和随访烦躁呓语的差异有统计学意义。结论 在小儿腹腔镜手术中，使用骶管阻滞复合气管插管全
麻与单纯全麻比较，呼吸、循环更平稳，诱导、苏醒和拔管时间更短，不良反应发生率更低。

      【关键词】 骶管阻滞；全麻；小儿；腹腔镜；Meta分析

      【中图分类号】 R726.1 【文献标识码】 A 【文章编号】 1003—6350（2015）20—3086—04


Clinical efficacy and safety of sacral block combined with general anesthesia in pediatric laparoscopic
operation: A meta-analysis.
SHEN Zi-ying, XIA Zhong-yuan, ZHAO Bo, LENG Yan, LIU Min, HOU Jia-bao.
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, CHINA

【Abstract】 Objective To evaluate the clinical effects and adverse reactions of sacral block combined with
general anesthesia in pediatric laparoscopic operation. Methods Articles have been retrieved in PubMed, Embase,
Cochrane Library, Chinese HowNet database, VIP, from database built to October 2014, and handled in inclusion
and exclusion criteria for data extraction and quality assessment, using RevMan 5.1.5 software for Meta-analysis.
Results A total of 9 randomized controlled trials were included, with a total of 528 patients. Compared with general
anesthesia, heart rate in sacral block combined tracheal intubation was more stable, with statistically significant differ-
ence between the two groups before tracheal intubation, 15 min after pneumoperitoneum and after extubation. The par-
tial pressure of end-tidal carbon dioxide (PETCO2) in sacral block combined tracheal intubation was more stable, with
significant difference 15 min after pneumoperitoneum; The induction time, wake-up time and extubation time were
shorter, with statistically significant difference. The postoperative adverse reactions were significantly less, with signif-
icant difference in restlessness, nausea, vomiting and balderdash. Conclusion In pediatric laparoscopic operation,
sacral block combined with tracheal intubation results in more stable circular and respiratory function, shorter time of
induction, wake-up and extubation, and lower incidence of adverse reactions, compared with simple general anesthesia.

      【Key words】 Sacral block; General anesthesia; Pediatric; Laparoscopic; Meta-analysis