小剂量舒芬太尼超前镇痛对小儿快通道腹腔镜术后疼痛及情绪的影响

摘要

Objective To observe the effects of low-dose sufentanil preemptive analgesia on children′s pain and emotion after fast-channel laparoscopic surgery .Methods Eighty children scheduled for fast-channel laparoscopic surgery were divided into two groups according to the random number table ,40 cases in each group .The observation group received intravenous injection of sulfentanil ( 0 .25 -0 .5 μg/kg ) 30 minutes before skin incision while the control group received equal volume of normal saline .Four,12 and 24 hours after operation ,the Wong-Banker FACES pain rating scale-revised ( FPS-R ) was used to assess the subjective analgesia effect , the pain observation scale for young children(POCIS) was used to assess objective analgesia effect ,and Ramsay scale was used to assess sedation effect.Results After operation,the FPS-R,POCIS and Ramsay scores decreased with increasing time in two groups (P<0.01),the FPS-R and POCIS scores in the observation group were lower than those in the control group (P<0.05), the Ramsay score in the observation group was higher than that in the control group (P<0.05).There were no significant adverse reactions in two groups .Conclusion Low-dose sufentanil preemptive analgesia applied to children undergoing fast-channel laparoscopic surgery can significantly alleviate postoperative pain ,stabilize the children′s emotion,and with high safety .%目的：观察小剂量舒芬太尼超前镇痛对小儿腹腔镜术后疼痛及情绪的影响。方法80例择期行快通道腹腔镜手术患儿按随机数字表分为两组，每组40例。切皮前30 min，观察组静脉注射舒芬太尼0．25～0．5μg/kg，对照组静脉注射相同容量的生理盐水。分别于术后4 h、12 h、24 h，用Wong-Banker面部表情量表法（FPS-R）评价主观镇痛效果，用儿童疼痛观察评分量表（POCIS）评价客观镇痛效果；用Ramsay法评价镇静效果。结果两者患儿术后镇痛效果FPS-R、POCIS评分及镇静Ramsay评分均随着时间延长而下降（ P＜0．01），且观察组FPS-R、POCIS评分均低于对照组（P＜0．05），镇静Ramsay评分高于对照组（P＜0．05）。两组均无明显不良反应发生。结论小剂量舒芬太尼超前镇痛在小儿快通道腹腔镜术的应用可减轻患儿术后疼痛，稳定患儿情绪，安全性高。