目的 观察在小儿腹腔镜疝内环结扎术中,以超前镇痛模式应用酮咯酸氨丁三醇的镇痛效果.方法 选择64例行腹腔镜疝内环结扎术的患儿,随机分为2组,各32例:试验组麻醉诱导前静脉给予酮咯酸氨丁三醇0.5 mg/kg,对照组麻醉诱导前不给予任何镇痛药物.术中采用气管插管静吸复合全身麻醉.统计术后30 min、1、2、4、6h的疼痛评分和术后5、10、20、30 min及1h的镇静评分,并观察不良反应的发生情况.结果 试验组术后6h内各时点疼痛评分均低于对照组,而2组术后1h内各时点镇静评分无明显差异.试验组术后躁动发生率明显低于对照组.结论 在小儿腹腔镜疝内环结扎术中,以超前镇痛模式应用酮咯酸氨丁三醇可以获得安全、有效的镇痛效果.%Objective To evaluate the analgesic effect of preemptive analgesia with ketorolac tromethamine in children undergoing laparoscopic hernia ligation. Methods Sixty- four children who were scheduled for laparoscopic hernia ligation were randomly divided into treatment group ( n = 32) in which preemptive analgesia was induced by ketorolac tromethamine at 0. 5 mg/kg before anesthesia and control group ( n = 32) in which no analgesic drug was given before anesthesia. Combination of inhalation and intravenous anesthesia was used in both groups. Pam intensity score was recorded 30 min, 1, 2, 4, 6 hours after operation and sedation score was recorded 5, 10, 20, 30 min, 1 h after operation. Results The pain score of the treatment group was significantly lower than that of the control group at all time points within 6 hours after operation. But no significant difference was observed in the sedation score between the two groups. Compared jtVith the control group, the incidence of postoperative agitation was lower in treatment group. Conclusion Preemptive analgesia with ketorolac tromethamine shows good analgesic effect and safety in children undergoing laparoscopic hernia ligatio.
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