单次经骶管注入不同麻醉药物对婴幼儿腹部手术后镇痛效果的比较

摘要

目的:观察婴幼儿腹部手术后经骶管单次注入不同麻醉药物的镇痛效果,探讨婴幼儿安全有效的术后镇痛方法.方法:60例行择期腹部手术患儿随机分为3组,每组20例.A组术毕经骶管注入0.1％布比卡因+芬太尼0.1 μg/kg,B组注入0.1％布比卡因,C组注入芬太尼0.1 μg/kg,注药量为1.0 mL/kg.记录各组患儿不同时间点的收缩压(SBP)、舒张压(DBP)、呼吸频率(RR)、心率(HR)、脉搏血氧饱和度(SpO2).记录手术时间、麻醉时间及住院时间.用FLACC量表评分法进行疼痛评分并随访不良反应的发生例数.结果:患儿FLACC评分在术后4h时A、B组低于C组(P＜0.05)；在术后8h时A组低于B、C组(P＜0.05).结论:术后单次经骶管注入布比卡因复合芬太尼,可为婴幼儿腹部术后提供较好的镇痛效果且副作用少,是一种安全、有效的镇痛方法,值得推广.%Objective:To observe the analgesia effect of postoperative using different drugs through sacral canal in pediatric operation on abdominal region,and research the effective postoperative analgesia method.Methods:Sixty children undergoing selective abdominal operation were randomly assigned to four groups.Group A used 0.1％ bupivacaine combined with 0.1 μg/kg fentanyl through sacral canal postoperatively,group B used 0.1％ bupivacaine,and group C used 0.1 μg/kg fentanyl.Systolic blood pressure (SBP),diastolic blood pressure (DBP),respiratory rate (RR),heart rate (HR) and saturation of blood oxygen (SpO2) were recorded at different time points,and the duration of surgery,the duration of analgesia and the hospital stay,the FLACC score and the side effect were also recorded.Results:The FLACC scores in groups A and B were significantly lower than those in group C at 4 h after the operation (P＜0.05).The FLACC scores in group A were significantly lower than those in groups B and C at 8 h after the operation (P＜0.05).Conclusion:Postoperative using bupivacaine combined with fentanyl through sacral canal can provide effective and safe postoperative analgesia for children undergoing abdominal operation.