罗哌卡因切口局部浸润用于小儿心脏手术后镇痛

摘要

目的 观察罗哌卡因切口局部浸润用于小儿心脏手术后镇痛的可行性和效果.方法 择期行房间隔缺损修补或室间隔缺损修补手术的小儿患者40例,随机均分为观察组和对照组.观察组于手术缝皮前,在切口周围局部浸润均匀注射0.3%罗哌卡因5～10 mL;对照组切口周围不施行罗哌卡因局部浸润.观察术后4,8,12,16,24 h患儿的平均动脉压、心率、FLACC评分.当FLACC评分>6分时,给予静脉注射咪达唑仑0.1 mg/kg.记录术后24 h 2组患儿咪达唑仑使用次数和使用量.结果 观察组术后8,12,16 h心率、FLACC评分低于对照组,术后24 h咪达唑仑使用次数和使用量少于对照组(P<0.05).结论 小儿心脏手术后在切口周围局部浸润注射0.3%罗哌卡因可在术后早期提供良好镇痛水平.%Objective To observe the effects of incision local infiltration with ropivacaine on post -rnoperative pain relief in pediatric patients undergoing cardiac surgery . Methods Forty pediatric patientsrnundergoing atrial septum defect repair or ventricular septal defect repair surgery , aged 1～7 years old,rnwith body weight 8～25 kg and ASA Ⅰ～Ⅱ level, were enrolled, and randomly divided into two groups ,rnthe experimental group and the control group , 20 cases in each . Local infiltration with 0.3% ropivacainernaround the incision before seam the skin were performed in the patients assigned to experimental group ,rnand not did the control group patients . The FLACC scores were graded by a unaware nurse at 4,8,12,rn16,24 hours postoperation. Once the score higher than 6 was graded, midazolam 0.1 mg/kg was injectedrnintravenous . The mean arterial pressure and heart rate were recorded at the corresponding time points .rnResults The heart rate and the FLACC scores at the 8,12,16 hours postoperation in the experimentalrngroup were lower than that in control group , and the times and doses of medazolam use throughout 24rnhours were lower respectively (P<0.05). Conclusion Incision local infiltration with 0.3% ropivacainernincrease postoperative pain relief in pediatric patients undergoing cardiac surgery .