布比卡因、吗啡复合液对小儿唇裂术后疼痛的影响

摘要

目的 观察布比卡因复合吗啡注射液应用于眶下神经阻滞对小儿唇裂术后镇痛的临床效果.方法 选择95例确诊为唇裂并行手术治疗的患儿,随机双盲分为布比卡因组(B组)47例和布比卡因、吗啡复合组(BM组)48例.常规诱导气管插管后,B组取0.25％布比卡因2 ml;BM组取0.25％布比卡因2 ml+1μg/kg吗啡注射液；两组均行双侧眶下神经阻滞,每侧1 ml.观察两组术后FLACC疼痛评分及不良反应.结果 两组患儿术后3、6小时FLACC评分差异无显著性(P＞0.05),术后12、24小时差异有显著性(P＜0.05),术后48小时差异有极显著性(P＜0.01).B组总不良反应发生率为14.89％,BM组16.67％.结论 采用布比卡因、吗啡复合液行眶下神经阻滞对小儿唇裂术后具有良好的镇痛效果,且不良反应少,麻醉安全性高.%Objective To study effects of bupivacaine and morphine combination with infraorbital nerve block on postoperative pain after cleft lip repair operation in paediatric patients.Methods 50 paediatric patients (ASA I) aged from 12 to 60 months undergoing cleft lip repair were randomly divided into two groups,25 cases for each group.After tracheal intubation,group B (using bupivacaine) received bilateral infraorbital nerve block with 1 ml of 0.25％ hupivacaine on each side and group BM (using bupivacaine and morphine combination) received 1 ml of 0.25％ bupivacaine along with 1 μ g/kg body weight morphine.Pain after recovery from anaesthesia was assessed postoperatively using the FLACC scale.Results Physical characteristics of the children studied had no significant differences.The duration of analgesia from the time of administration of block in group B was (20.2 ± 2.6) h compared to (36.8 ± 3.4) h in group BM (P＜0.01).Between two groups,the FLACC scale in group B was higher at 12,24 and 48 h postoperatively than those in group BM (P＜0.01).Conclusion Addition of morphine as an adjunct to local anaesthetic significantly prolongs the duration of postoperative analgesia without any adverse effects.